In this section
@article{Davies:2025:10.1136/bmjopen-2024-086150,
author = {Davies, A and Sabharwal, S and Zamora, Talaya B and Liddle, A and Vella-Baldacchino, M and Rangan, A and Reilly, P},
doi = {10.1136/bmjopen-2024-086150},
journal = {BMJ Open},
title = {Cost-effectiveness of total shoulder arthroplasty compared to hemiarthroplasty. A study using data from the National Joint Registry},
url = {http://dx.doi.org/10.1136/bmjopen-2024-086150},
volume = {15},
year = {2025}
}
TY - JOUR
AB - Objectives The aim of this study was to compare the cost-effectiveness of total shoulder arthroplasty (TSA) and hemiarthroplasty (HA) and explore variation by age and gender.Design Cost-effectiveness analysis using a lifetime cohort Markov model.Setting National population registry data.Participants Model parameters were informed by propensity score-matched comparisons of TSA and HA in patients with osteoarthritis and an intact rotator cuff using data from the National Joint Registry.Interventions TSA and HA.Primary outcome measures Quality-adjusted life years (QALYs) and healthcare costs for age and gender subgroups. A probabilistic sensitivity analysis was performed.Results In all subgroups, TSA was more cost-effective, with the probability of being cost-effective about 70% for TSA versus 30% for HA at any willingness-to-pay threshold above £1100 per QALY. TSA was dominant in young patients (≤60 years) with a mean cost saving of £463 in men and £658 in women, and a mean QALY gain of 2 in both men and women. In patients aged 61–75 years, there was a mean cost saving following HA of £395 in men and £181 in women, while QALYs remained superior following TSA with a 1.3 gain in men and 1.4 in women. In the older cohort (> 75 years), the cost difference was highest and the QALY difference was lowest; there was a cost-saving following HA of £905 in men and £966 in women. The mean QALY gain remained larger after TSA: 0.7 in men and 0.9 in women.Conclusion TSA was more cost-effective than HA in patients with osteoarthritis. QALYs were superior following TSA in all patient groups. Cost differences varied by age and TSA was dominant in young patients.
AU - Davies,A
AU - Sabharwal,S
AU - Zamora,Talaya B
AU - Liddle,A
AU - Vella-Baldacchino,M
AU - Rangan,A
AU - Reilly,P
DO - 10.1136/bmjopen-2024-086150
PY - 2025///
SN - 2044-6055
TI - Cost-effectiveness of total shoulder arthroplasty compared to hemiarthroplasty. A study using data from the National Joint Registry
T2 - BMJ Open
UR - http://dx.doi.org/10.1136/bmjopen-2024-086150
UR - https://bmjopen.bmj.com/content/15/3/e086150.info
VL - 15
ER -