Cost effectiveness of treatment with percutaneous Kirschner wires versus volar locking plate for adult patients with a dorsally displaced fracture of the distal radius : analysis from the DRAFFT trial

Tubeuf, Sandy;Yu, Ge;Achten, Juul;Parsons, Nick R;Costa, Matthew L.;et.al.
(2015) The Bone & Joint Journal — Vol. 97-B, n° 8, p. 1082-1089 (2015)

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Authors
  • Tubeuf, Sandyorcid-logoUCLouvain
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  • Yu, Ge
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  • Achten, Juul
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  • Parsons, Nick R
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  • Costa, Matthew L.
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Abstract
We present an economic evaluation using data from the Distal Radius Acute Fracture Fixation Trial (DRAFFT) to compare the relative cost effectiveness of percutaneous Kirschner wire (K-wire) fixation and volar locking-plate fixation for patients with dorsally-displaced fractures of the distal radius. The cost effectiveness analysis (cost per quality-adjusted life year; QALY) was derived from a multi-centre, two-arm, parallel group, assessor-blind, randomised controlled trial which took place in 18 trauma centres in the United Kingdom. Data from 460 patients were available for analysis, which includes both a National Health Service cost perspective including costs of surgery, implants and healthcare resource use over a 12-month period after surgery, and a societal perspective, which includes the cost of time off work and the need for additional private care. There was only a small difference in QALYs gained for patients treated with locking-plate fixation over those treated with K-wires. At a mean additional cost of £714 (95% confidence interval 588 to 865) per patient, locking-plate fixation presented an incremental cost effectiveness ratio (ICER) of £89 322 per QALY within the first 12 months of treatment. Sensitivity analyses were undertaken to assess the ICER of locking-plate fixation compared with K-wires. These were greater than £30 000. Compared with locking-plate fixation, K-wire fixation is a ‘cost saving’ intervention, with similar health benefits.
Affiliations
  • Academic Unit of Health EconomicsUniversity of Leeds

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Tubeuf, S., Yu, G., Achten, J., Parsons, N. R., Rangan, A., Lamb, S. E., & Costa, M. L. (2015). Cost effectiveness of treatment with percutaneous Kirschner wires versus volar locking plate for adult patients with a dorsally displaced fracture of the distal radius : analysis from the DRAFFT trial. The Bone & Joint Journal, 97-B(8), 1082-1089. https://doi.org/10.1302/0301-620x.97b8.35234 (Original work published 2015)