Trends in cost effectiveness analyses in orthopaedic surgery

UMMS Affiliation

Department of Quantitative Health Sciences

Publication Date


Document Type



Cost-Benefit Analysis; Databases, Factual; Evidence-Based Medicine; Health Care Costs; Humans; Orthopedics


Biostatistics | Epidemiology | Health Services Research


Worldwide, programs dealing with musculoskeletal health are required to set priorities and allocate resources within the constraint of limited funding. There is increasing pressure for medical technology assessment, which traditionally has involved evaluating safety and effectiveness, to also include consideration of cost effectiveness. We updated our database of orthopaedic cost-effectiveness studies, critically reviewed their methods, and examined trends over time. Current analyses have numerous shortcomings, such as the inclusion of relatively few studies, inconsistent methodologic approaches, and lack of transparency. The wide variation in cost-effectiveness ratios observed among current interventions suggests efficiency can be improved. Despite reimbursement authorities in many other countries formally considering cost-effectiveness when determining coverage of new technologies, Medicare has been resistant to considering costs of treatments. Regardless of this policy deficiency, conducting cost-effectiveness analyses represents a prudent step forward in illuminating the tradeoffs involved in difficult resource allocation decisions, and there is an urgent need to consider economic impact in future studies using standardized and transparent methods.

DOI of Published Version



Clin Orthop Relat Res. 2007 Apr;457:42-8. Link to article on publisher's site

Journal/Book/Conference Title

Clinical orthopaedics and related research

PubMed ID


Related Resources

Link to Article in PubMed