EP1.6 Cost-Utility Analysis of Osteochondroplasty Compared to Lavage for Treatment of Young Adults with Femoroacetabular Impingement in Canada

Objective: To conduct a cost-utility analysis of osteochondroplasty compared to lavage for femoroacetabular impingement (FAI) from a Canadian public payer perspective.

Methods: A Markov model was constructed to compare the lifetime quality-adjusted life years (QALYs) and costs of the two treatment strategies. The target population was surgical FAI patients aged 36 years. The primary data source was patient-level data from the Femoroacetabular Impingement Randomised Controlled Trial (FIRST), which evaluated the efficacy of the surgical correction of femoroacetabular impingement (FAI) via arthroscopic osteochondroplasty compared with arthroscopic lavage with or without labral repair. Long-term data were extrapolated using a generalized gamma model. The primary outcome was the incremental cost-effectiveness ratio (ICER), calculated by dividing the difference in costs by the difference in QALYs between osteochondroplasty and lavage. Probabilistic sensitivity analyses and one-way sensitivity analyses were used to characterize uncertainty of model parameters and assumptions.

Results: Over a lifetime horizon, osteochondroplasty had a greater expected benefit (0.63 QALYs gained per patient) and lower costs ($955.89 saved per patient), as compared with lavage. Probabilistic sensitivity analyses demonstrated that the probability of osteochondroplasty being cost-effective was 90.5% at a commonly used willingness-to-pay threshold of $50,000/QALY. Across all one-way sensitivity analyses, osteochondroplasty remained a cost-effective option.

Conclusion: Over a lifetime time horizon, osteochondroplasty is a cost-effective treatment strategy for young adults with FAI. Future research involving real-word data is needed to further validate these findings.