Ronaldson, Sarah J orcid.org/0000-0001-8321-786X, Cook, Elizabeth orcid.org/0000-0001-6902-0235, Mitchell, Alex orcid.org/0000-0001-9311-2092 et al. (4 more authors) (2024) Cost-effectiveness of a two-layer compression bandage versus standard bandage following total knee arthroplasty. Bone & Joint Open. pp. 550-559. ISSN 2633-1462
Abstract
AIMS: To assess the cost-effectiveness of a two-layer compression bandage versus a standard wool and crepe bandage following total knee arthroplasty, using patient-level data from the Knee Replacement Bandage Study (KReBS). METHODS: A cost-utility analysis was undertaken alongside KReBS, a pragmatic, two-arm, open label, parallel-group, randomized controlled trial, in terms of the cost per quality-adjusted life year (QALY). Overall, 2,330 participants scheduled for total knee arthroplasty (TKA) were randomized to either a two-layer compression bandage or a standard wool and crepe bandage. Costs were estimated over a 12-month period from the UK NHS perspective, and health outcomes were reported as QALYs based on participants' EuroQol five-dimesion five-level questionnaire responses. Multiple imputation was used to deal with missing data and sensitivity analyses included a complete case analysis and testing of costing assumptions, with a secondary analysis exploring the inclusion of productivity losses. RESULTS: The base case analysis found participants in the compression bandage group accrued marginally fewer QALYs, on average, compared with those in the standard bandage group (reduction of 0.0050 QALYs (95% confidence interval (CI) -0.0051 to -0.0049)), and accumulated additional mean costs (incremental cost of £52.68 per participant (95% CI 50.56 to 54.80)). Findings remained robust to assumptions tested in sensitivity analyses, although considerable uncertainty surrounded the outcome estimates. CONCLUSION: Use of a two-layer compression bandage is marginally less effective in terms of health-related quality of life, and more expensive when compared with a standard bandage following TKA, so therefore is unlikely to provide a cost-effective option.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2024 Ronaldson et al. |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Sciences (York) > Health Sciences (York) |
Depositing User: | Pure (York) |
Date Deposited: | 11 Jul 2024 10:10 |
Last Modified: | 02 Apr 2025 23:28 |
Published Version: | https://doi.org/10.1302/2633-1462.57.BJO-2023-0153... |
Status: | Published |
Refereed: | Yes |
Identification Number: | 10.1302/2633-1462.57.BJO-2023-0153.R1 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:214700 |
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Filename: 2633-1462.57.BJO-2023-0153.R1.pdf
Description: 2633-1462.57.BJO-2023-0153.R1
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