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Cost-Effectiveness Analysis of Cervical Anterior Fusion and Cervical Artificial Disc Replacement in the Korean Medical System

Journal of Korean Neurosurgical Society 2019년 62권 1호 p.83 ~ 89
 ( Lee Hyo-Sang ) - Serim Hospital

 ( Kim Ui-Chul ) - Yonsei University College of Medicine Severance Hospital Department of Neurosurgery
 ( Oh Jae-Keun ) - Hallym University Sacred Heart Hospital Department of Neurosurgery
 ( Kim Tae-Hyun ) - Yonsei University Graduate School of Public Health
 ( Park So-Hee ) - Yonsei University Graduate School of Public Health
 ( Ha Yoon ) - Yonsei University College of Medicine Severance Hospital Department of Neurosurgery

Abstract


Objective: This study is a retrospective cost-benefit analysis of cervical anterior interbody fusion and cervical artificial disc replacement, which are the main surgical methods to treat degenerative cervical disc disease.

Methods: We analyzed 156 patients who underwent anterior cervical disc fusion and cervical artificial disc replacement from January 1, 2008 to December 31, 2009, diagnosed with degenerative cervical disc disorder. In this study, the costs and benefits were analyzed by using quality adjusted life year (QALY) as the outcome index for patients undergoing surgery, and a Markov model was used for the analysis. Only direct medical costs were included in the analysis; indirect medical costs were excluded. Data were analyzed with TreeAge Pro 2015™ (TreeAge Software, Inc, Williamstown, MA, USA).

Results: Patients who underwent cervical anterior fusion had a total cost of KRW 2501807/USD 2357 over 5 years and obtained a utility of 3.72 QALY. Patients who underwent cervical artificial disc replacement received 4.18 QALY for a total of KRW 3685949/USD 3473 over 5 years. The cumulative cost-effectiveness ratio of cervical spine replacement surgery was KRW 2549511/QALY (USD 2402/QALY), which was lower than the general Korean payment standard.

Conclusion: Both cervical anterior fusion and cervical artificial disc replacement are cost-effective treatments for patients with degenerative cervical disc disease. Cervical artificial disc replacement may be an effective alternative to obtain more benefits.

키워드

Cost-effectiveness analysis; Quality-adjusted life years; Cervical vertebrae; Total disc replacement; Spinal fusion
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