A PRELIMINARY COST-UTILITY ANALYSIS OF THE PROSTHETIC CARE INNOVATIONS: CASE OF THE KEEP WALKING IMPLANT

Lluis Guirao; Beatriz  Samitier; Laurent Frossard

doi:10.33137/cpoj.v4i2.36366

Authors

Lluis Guirao Servicio de Rehabilitaión - Hospital Asepeyo Sant Cugat, Barcelona, Spain. https://orcid.org/0000-0002-8698-9483
Beatriz Samitier Servicio de Rehabilitaión - Hospital Asepeyo Sant Cugat, Barcelona, Spain https://orcid.org/0000-0002-7679-2775
Laurent Frossard 1) YourResearchProject Pty Ltd, Brisbane, Australia. 2) Griffith University, Gold Coast, Australia. 3) University of the Sunshine Coast, Maroochydore, Australia. 4) Queensland University of Technology, Brisbane, Australia. http://orcid.org/0000-0002-0248-9589

DOI:

https://doi.org/10.33137/cpoj.v4i2.36366

Keywords:

Artificial Limbs, Bone-Anchored Prosthesis, Cost-Effectiveness, Cost-Utility, Distal Weight Bearing Implant, Osseointegration, Prosthesis

Abstract

Several obstacles must be overcome before preliminary cost-utility analyses (CUA) of prosthetic care innovations can be routinely performed. The basic framework of preliminary CUAs and hands-on recommendations suggested previously might contribute to wider adoption. However, a practical application for an emerging intervention is needed to showcase the capacity of this proposed preliminary CUA framework. This study presented the outcomes of preliminary CUA of the distal weight bearing Keep Walking Implant (KWI), an emerging prosthetic care innovation that may reduce socket fittings for individuals with transfemoral amputation. The preliminary CUAs compared the provision of prosthetic care without (usual intervention) and with the KWI (new intervention) using a 15-step iterative process focused on feasibility, constructs, analysis, and interpretations of outcomes from an Australia government prosthetic care perspective over a six-year time horizon. Baseline and incremental costs were extracted from schedules of allowable expenses. Baseline utilities were extracted from a study and converted into quality-adjusted life-year (QALY). Incremental utilities were calculated based on sensible gains of QALY from baselines. The provision of the prosthetic care with the KWI could generate an indicative incremental cost-utility ratio (ICUR) of -$36,890 per QALY, which was $76,890 per QALY below willingness-to-pay threshold, provided that the KWI reduces costs by $17,910 while increasing utility by 0.485 QALY compared to usual interventions. This preliminary CUA provided administrators of healthcare organizations in Australia and elsewhere with prerequisite evidence justifying further access to market and clinical introduction of the KWI. Altogether, this work suggests that the basic framework of the preliminary CUA of a prosthetic care innovation proposed previously is feasible and informative when a series of assumptions are carefully considered. This study further confirms that preliminary CUAs prosthetic care interventions might be a relevant alternative to full CUA for other medical treatments.

Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/36366/28329

How To Cite: Guirao L, Samitier B, Frossard L. A preliminary cost-utility analysis of the prosthetic care innovations: case of the keep walking implant. Canadian Prosthetics & Orthotics Journal. 2021; Volume 4, Issue 2, No.11. https://doi.org/10.33137/cpoj.v4i2.36366

Corresponding Author: Laurent Frossard (PhD), Professor of Bionics
YourResearchProject Pty Ltd, Brisbane, Australia.
E-Mail: laurentfrossard@outlook.com
ORCID number: https://orcid.org/0000-0002-0248-9589

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Author Biographies

Lluis Guirao, Servicio de Rehabilitaión - Hospital Asepeyo Sant Cugat, Barcelona, Spain.

Dr Lluis Guirao graduated from Barcelona Medical School at Universidad Central de Barcelona in 1993. He works as a Specialist in Physical Medicine and Rehabilitation at Hospital Asepeyo Sant Cugat since 2018. He is also a Professor at the Sonography School of the Spanish Rehabilitation Society-EcoSERMEF and at San Pablo Andalucia CEU Institute. Dr Lluis Guirao is the principal investigator of the Keep Walking project (distal femoral implant) with the TEQUIR S. L. team.

Beatriz Samitier , Servicio de Rehabilitaión - Hospital Asepeyo Sant Cugat, Barcelona, Spain

Dr Beatriz Samitier graduated in Medicine and Surgery from University of Zaragoza. She became a Specialist in Physical Medicine and Rehabilitation in 2007 and obtained a PhD from Universitat Autónoma Barcelona-UAB. She is currently working as a Physical Medicine and Rehabilitation Specialist in the Rehabilitation Department in Asepeyo Sant Cugat Hospital, Barcelona (Spain). Dr Beatriz Samitier is also a Professor at the Sonography School of the Spanish Rehabilitation Society-EcoSERMEF and at San Pablo Andalucia CEU Institute.

Laurent Frossard, 1) YourResearchProject Pty Ltd, Brisbane, Australia. 2) Griffith University, Gold Coast, Australia. 3) University of the Sunshine Coast, Maroochydore, Australia. 4) Queensland University of Technology, Brisbane, Australia.

Dr Laurent Frossard is a bionic limbs scientist who is passionate about developing ground-breaking prosthetic solutions to improve the lives of individuals suffering from limb loss. He is internationally recognized as a researcher and an independent expert for his unique expertise in bionic limbs. He approaches bionic solutions from a holistic perspective, by integrating the prosthetic biomechanics, clinical benefits, service delivery, and health economics. Dr Frossard has over 25 years of experience, both in academia and in private industries in Australia, Canada, and Europe. He has collaborated with over 100 organizations worldwide. He is currently a Professor of bionics at the Griffith University, the Director and Chief Scientist Officer at YourResearchProject Pty Ltd, and Adjunct Professor at the Queensland University of Technology and the University of Sunshine Coast in Australia.

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