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ToolsGoacher, Edward, Yardanov, Stefan, Phillips, Richard, Budu, Alexandru, Dyson, Edward, Ivanov, Marcel, Barton, Garry, Hutton, Mike, Gardner, Adrian, Quraish, Nasir A., Grahovac, Gordan, Jung, Josephine, Demetriades, Andreas K., Vergara, Pierluigi, Pereira, Erlick, Arzoglou, Vasileios, Francis, Jibin, Trivedi, Rikin, Davies, Benjamin M. and Kotter, Mark R. N. (2024) Cost-effectiveness of surgery for degenerative cervical myelopathy in the United Kingdom. British Journal of Neurosurgery. ISSN 1360-046X
Full text not available from this repository. (Request a copy)Abstract
Purpose: Degenerative cervical myelopathy (DCM) is the commonest cause of adult spinal cord dysfunction worldwide, for which surgery is the mainstay of treatment. At present, there is limited literature on the costs associated with the surgical management of DCM, and none from the United Kingdom (UK). This study aimed to evaluate the cost-effectiveness of DCM surgery within the National Health Service, UK. Materials and Methods: Incidence of DCM was identified from the Hospital Episode Statistics (HES) database for a single year using five ICD-10 diagnostic codes to represent DCM. Health Resource Group (HRG) data was used to estimate the mean incremental surgery (treatment) costs compared to non-surgical care, and the incremental effect (quality adjusted life year (QALY) gain) was based on data from a previous study. A cost per QALY value of <£30,000/QALY (GBP) was considered acceptable and cost-effective, as per the National Institute for Health and Clinical Excellence (NICE) guidance. A sensitivity analysis was undertaken (±5%, ±10% and ±20%) to account for variance in both the cost of admission and QALY gain. Results: The total number of admissions for DCM in 2018 was 4,218. Mean age was 62 years, with 54% of admissions being of working age (18–65 years). The overall estimated cost of admissions for DCM was £38,871,534 for the year. The mean incremental (per patient) cost of surgical management of DCM was estimated to be £9,216 (ranged £2,358 to £9,304), with a QALY gain of 0.64, giving an estimated cost per QALY value of £14,399/QALY. Varying the QALY gain by ±20%, resulted in cost/QALY figures between £12,000 (+20%) and £17,999 (−20%). Conclusions: Surgery is estimated to be a cost-effective treatment of DCM amongst the UK population.
| Item Type: | Article |
|---|---|
| Additional Information: | Funding information: MRNK is supported by a NIHR Clinician Scientist Award and BMD a NIHR Clinical Doctoral Research Fellowship. Disclaimer: This report is independent research arising from a Clinician Scientist Award, CS-2015-15-023, supported by the National Institute for Health Research. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health and Social Care. |
| Uncontrolled Keywords: | cervical,cost,degeneration,myelopathy,surgery,clinical neurology,surgery,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2728 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Centres > Population Health Faculty of Medicine and Health Sciences > Research Groups > Health Economics Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 12 Jul 2024 14:31 |
| Last Modified: | 25 Sep 2024 17:48 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/95908 |
| DOI: | 10.1080/02688697.2024.2346566 |
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