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Cost-Effectiveness of XRT vs. NSAIDs for Prevention of HO after Hip Arthroplasty

Cost-Effectiveness of XRT vs. NSAIDs for Prevention of HO after Hip Arthroplasty. Jonathan B. Strauss MD, MBA Sea S. Chen MD, PhD Anand P. Shah MD Alan B. Coon MD, PhD Adam T. Dickler MD. Cost Effectiveness of XRT for HO. Rationale: XRT superior to NSAIDs for HO prophylaxis

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Cost-Effectiveness of XRT vs. NSAIDs for Prevention of HO after Hip Arthroplasty

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  1. Cost-Effectiveness of XRT vs. NSAIDs for Prevention of HO after Hip Arthroplasty Jonathan B. Strauss MD, MBA Sea S. Chen MD, PhD Anand P. Shah MD Alan B. Coon MD, PhD Adam T. Dickler MD

  2. Cost Effectiveness of XRT for HO • Rationale: • XRT superior to NSAIDs for HO prophylaxis • Some have questioned the cost effectiveness of XRT • Cost of administering XRT far exceeds that of NSAIDs • However, this incomplete analysis fails to account for costs of treatment failure and morbidity

  3. Cost Effectiveness of XRT for HO • The risk of treatment failure (Brooker 3-4) estimated from meta-analysis XRT: 0.9% vs. NSAIDs: 2.9% • Additional rate of GI bleed 0.9% vs. 2.5% • Our analysis included: • Direct medical cost of admission and re-operation per case ($24,132.56) • Direct medical cost of hospitalization for GI bleed per case ($9,581.78) • Indirect cost of missed work days per hospitalization ($85.94)

  4. Cost Effectiveness of XRT for HO Costs are calculated on a per patient basis (cost per case x % of patients affected)

  5. Cost Effectiveness of XRT for HO • When the costs of treatment failures and treatment morbidity are added, the cost of XRT is similar to NSAIDs • This analysis does not account for QOL impairment caused by GI bleed or HO recurrence • These costs push balance in favor of XRT

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