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Health Economic Rationale in Prosthetic Services
Andreas Hahn, PhD; MSc
Health technology assessment and health economic (HE) value proposition play increasingly important roles in a modern health care systems. Increasing pressure by demographic change forces specifically public health care to allocate resources where most value is being created. Next to an increase in level of clinical evidence, health economic arguments shall become increasingly vital. The recent inquiry of the United States Agency for Health Care Research and Quality with respect to lower limb prosthetics are a manifestation of this trend. Despite common perception is the application of specific HE instruments comparably simple, of very reasonable costs and well valuated.
We like to point to two talks were we address the subject during this conference. On Saturday the 5th we discuss the measurements of health utilities in two larger cohorts in Germany and in India. We stratify for etiology and mobility grades and investigate the health utility value of components as C-Leg, Genium and Kenevo. On Monday we present a health-economic analysis calculating incremental cost effectiveness ratios when considering the impact of the microprocessor controlled C-Leg on falls avoidance in an elderly population. The high impact of falls avoidance is resembled not only in a strong cost effectiveness and compare well to those presented earlier by Lui et al. in the RAND findings (Fig1.). We can also show a very substantial reduction of lethal falls in elderly subjects with vascular etiology.
Figure 1 shows the incremental Cost Effectiveness Ratio for C-Leg in an elderly population in Germany. The amounts of approx. USD 14.000 per Quality Adjusted Life Year gained compare well with established and accepted methods such MRA, TKA or PTA. Figure 2: Picture of KENEVO