Cost-effectiveness of C-leg compared with non-microprocessor-controlled knees: a modeling approach.

OBJECTIVE To estimate the costs and health outcomes of C-Leg and non-microprocessor-controlled (NMC) knees using a decision-analytic model. DESIGN Data on costs, rates and duration of problems, knee survival, and health-related quality of life were obtained from interviews with patients and prosthetists with experience of both C-Leg and NMC knees. Interview data were assessed in a decision-analytic Markov model to estimate cost-effectiveness from a health care perspective. SETTING Outpatient. PARTICIPANTS A population sample of 20 patients currently using the C-Leg and prior experience of nonmicroprocessor knees, and 5 prosthetists. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE Incremental cost per quality-adjusted life year (QALY). RESULTS The mean incremental cost (in 2006 Euros) and QALYs for the C-Leg was 7657 euros and 2.38, respectively, yielding a cost per QALY gained of 3218 euros. CONCLUSIONS It is important to provide decision-makers with relevant information on costs and health outcomes of different treatment strategies on actual decision problems despite limited evidence. The results of the study, taking into account both costs and a broadly defined health outcome in terms of QALY, show that given existing albeit limited evidence the C-Leg appears to yield positive health outcomes at an acceptable cost.