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The Kenevo microprocessor-controlled prosthetic knee compared with non–microprocessor-controlled knees in individuals older than 65 years in Sweden: A cost-effectiveness and budget-impact analysis

Growing evidence suggests that individuals with transfemoral amputation or knee disarticulation using a prosthesis equipped with a microprocessor-controlled knee (MPK) benefit from enhanced mobility and safety, including less falls. In elderly individuals, high mortality rates are assumed to reduce...

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Autores principales: Kuhlmann, Alexander, Hagberg, Kerstin, Kamrad, Ilka, Ramstrand, Nerrolyn, Seidinger, Susanne, Berg, Hans
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9554759/
https://www.ncbi.nlm.nih.gov/pubmed/35511441
http://dx.doi.org/10.1097/PXR.0000000000000138
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author Kuhlmann, Alexander
Hagberg, Kerstin
Kamrad, Ilka
Ramstrand, Nerrolyn
Seidinger, Susanne
Berg, Hans
author_facet Kuhlmann, Alexander
Hagberg, Kerstin
Kamrad, Ilka
Ramstrand, Nerrolyn
Seidinger, Susanne
Berg, Hans
author_sort Kuhlmann, Alexander
collection PubMed
description Growing evidence suggests that individuals with transfemoral amputation or knee disarticulation using a prosthesis equipped with a microprocessor-controlled knee (MPK) benefit from enhanced mobility and safety, including less falls. In elderly individuals, high mortality rates are assumed to reduce the expected useful life of MPKs, and this raises concerns regarding their economic effectiveness. OBJECTIVE: To investigate the cost-effectiveness and budget impact of the Kenevo/MPK (Ottobock, Germany) compared with non–microprocessor-controlled knees (NMPKs) in people older than 65 years at the time of transfemoral amputation/knee disarticulation, from a Swedish payer’s perspective. METHODS: A decision-analytic model was developed to conduct the economic analysis of the Kenevo/MPK. Model parameters were derived from Swedish databases and published literature. Univariate and probabilistic sensitivity analyses were performed to explore parameter uncertainty. RESULTS: Compared with NMPKs, the Kenevo/MPK reduced the frequency of hospitalizations by 137 per 1,000 person years while the frequency of fatal falls was reduced by 19 per 1,000 person-years in the simulation. Over a 25-year time horizon, the incremental cost-effectiveness ratio was EUR11,369 per quality-adjusted life year. The probability of the MPK being cost-effective at a threshold of EUR40,000 per quality-adjusted life year was 99%. The 5-year budget impact model predicted an increase in payer expenditure of EUR1.76 million if all new patients received a Kenevo/MPK, and 50% of current NMPK users switched to the MPK. CONCLUSIONS: Results of the modeling suggest that the Kenevo/MPK is likely to be cost-effective for elderly individuals, primarily because of a reduction in falls.
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spelling pubmed-95547592022-10-19 The Kenevo microprocessor-controlled prosthetic knee compared with non–microprocessor-controlled knees in individuals older than 65 years in Sweden: A cost-effectiveness and budget-impact analysis Kuhlmann, Alexander Hagberg, Kerstin Kamrad, Ilka Ramstrand, Nerrolyn Seidinger, Susanne Berg, Hans Prosthet Orthot Int Original Research Report Growing evidence suggests that individuals with transfemoral amputation or knee disarticulation using a prosthesis equipped with a microprocessor-controlled knee (MPK) benefit from enhanced mobility and safety, including less falls. In elderly individuals, high mortality rates are assumed to reduce the expected useful life of MPKs, and this raises concerns regarding their economic effectiveness. OBJECTIVE: To investigate the cost-effectiveness and budget impact of the Kenevo/MPK (Ottobock, Germany) compared with non–microprocessor-controlled knees (NMPKs) in people older than 65 years at the time of transfemoral amputation/knee disarticulation, from a Swedish payer’s perspective. METHODS: A decision-analytic model was developed to conduct the economic analysis of the Kenevo/MPK. Model parameters were derived from Swedish databases and published literature. Univariate and probabilistic sensitivity analyses were performed to explore parameter uncertainty. RESULTS: Compared with NMPKs, the Kenevo/MPK reduced the frequency of hospitalizations by 137 per 1,000 person years while the frequency of fatal falls was reduced by 19 per 1,000 person-years in the simulation. Over a 25-year time horizon, the incremental cost-effectiveness ratio was EUR11,369 per quality-adjusted life year. The probability of the MPK being cost-effective at a threshold of EUR40,000 per quality-adjusted life year was 99%. The 5-year budget impact model predicted an increase in payer expenditure of EUR1.76 million if all new patients received a Kenevo/MPK, and 50% of current NMPK users switched to the MPK. CONCLUSIONS: Results of the modeling suggest that the Kenevo/MPK is likely to be cost-effective for elderly individuals, primarily because of a reduction in falls. Wolters Kluwer 2022-10 2022-05-03 /pmc/articles/PMC9554759/ /pubmed/35511441 http://dx.doi.org/10.1097/PXR.0000000000000138 Text en Copyright © 2022 The Authors. Published by Wolters Kluwer incorporated on behalf of The International Society for Prosthetics and Orthotics. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Original Research Report
Kuhlmann, Alexander
Hagberg, Kerstin
Kamrad, Ilka
Ramstrand, Nerrolyn
Seidinger, Susanne
Berg, Hans
The Kenevo microprocessor-controlled prosthetic knee compared with non–microprocessor-controlled knees in individuals older than 65 years in Sweden: A cost-effectiveness and budget-impact analysis
title The Kenevo microprocessor-controlled prosthetic knee compared with non–microprocessor-controlled knees in individuals older than 65 years in Sweden: A cost-effectiveness and budget-impact analysis
title_full The Kenevo microprocessor-controlled prosthetic knee compared with non–microprocessor-controlled knees in individuals older than 65 years in Sweden: A cost-effectiveness and budget-impact analysis
title_fullStr The Kenevo microprocessor-controlled prosthetic knee compared with non–microprocessor-controlled knees in individuals older than 65 years in Sweden: A cost-effectiveness and budget-impact analysis
title_full_unstemmed The Kenevo microprocessor-controlled prosthetic knee compared with non–microprocessor-controlled knees in individuals older than 65 years in Sweden: A cost-effectiveness and budget-impact analysis
title_short The Kenevo microprocessor-controlled prosthetic knee compared with non–microprocessor-controlled knees in individuals older than 65 years in Sweden: A cost-effectiveness and budget-impact analysis
title_sort kenevo microprocessor-controlled prosthetic knee compared with non–microprocessor-controlled knees in individuals older than 65 years in sweden: a cost-effectiveness and budget-impact analysis
topic Original Research Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9554759/
https://www.ncbi.nlm.nih.gov/pubmed/35511441
http://dx.doi.org/10.1097/PXR.0000000000000138
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