The researchers examined 33 patients who underwent surgery with rhBMP-2 with either local bone autograft or iliac crest bone graft and compared those patients with 42 patients who received only local bone autograft or ICBG. The researchers found:
1. The one year cost-utility ratio for the control group was significantly lower than the rhBMP-2 group. The control group reported $143,251 per QALY gained while the rhBMP-2 group reported $272,414 per QALY gained.
2. One year after surgery, the control group dominated the incremental cost-effectiveness ratio when compared with the rhBMP-2 group.
3. There were significant and clinically relevant improvements in both cohorts.
4. If there are double per year gains in QALY, two years after spinal fusion with the autograft but without rhBMP-2, the procedure would be cost effective at $71,625 per QALY gained.
5. Two years after fusion, the patients who received both autograft and rhBMP-2 wouldn’t be cost-effective at $136,207 per QALY gained, assuming the cost-effectiveness threshold is $100,000 QALY gained.
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