A new study published in The Spine Journal examines the impact of cost valuation and cost-effectiveness among adult spinal deformity patients.
The researchers examined 580 surgical adult spinal deformity patients over a two year period, 346 of which completed baseline and two-year data. There were 60 Medicare beneficiaries. The consecutive patients were enrolled in a database for adult spinal deformity surgery at a single institution over a five-year period: 2008 to 2013.
Here are five key notes on the results:
1. The average SF-6D gained was 0.10 during the first year and 0.02 in the second year. The cumulative SF-6D gained over the two-year period was 0.12.
2. The Medicare allowable rates over the two-year period ranged from $42,383 to $220,749. The average rate was $82,050.
3. Average direct costs for the procedure ranged from $28,447 to $217,717. The average cost was $99,114.
4. The average cost per QALY over the two-year period was $683,750 based on the Medicare allowable rates and $825,950 using direct costs.
5. There was a $17,181 cost difference between the two calculations, a 17 percent difference on whole. The difference was statistically significant.
"Utilizing Medicare allowable rates not only underestimates the cost of ASD surgery, but it creates inaccurate and unrealistic expectations for researchers and policymakers," concluded the study authors.