{Reference Type}: Journal Article
{Title}: Can Robotic Arm-assisted Total Knee Arthroplasty Remain Cost-effective in Volume-based Procurement System in China? A Markov Model-based Study.
{Author}: Zhang Z;Luo Y;Zhang J;Zhang C;Wang X;Chen J;Chai W;
{Journal}: Orthop Surg
{Volume}: 16
{Issue}: 6
{Year}: 2024 Jun 1
{Factor}: 2.279
{DOI}: 10.1111/os.14078
{Abstract}: <B>OBJECTIVE: </B>The volume based procurement (VBP) program in China was initiated in 2022. The cost-effectiveness of robotic arm assisted total knee arthroplasty is yet uncertain after the initiation of the program. The objective of the study was to investigate the cost-effectiveness of robotic arm-assisted total knee arthroplasty and the influence of the VBP program to its cost-effectiveness in China.<BR><B>METHODS: </B>The study was a Markov model-based cost-effectiveness study. Cases of primary total knee arthroplasty from January 2019 to December 2021 were included retrospectively. A Markov model was developed to simulate patients with advanced knee osteoarthritis. Manual and robotic arm-assisted total knee arthroplasties were compared for cost-effectiveness before and after the engagement of the VBP program in China. Probability and sensitivity analysis were conducted.<BR><B>RESULTS: </B>Robotic arm-assisted total knee arthroplasty showed better recovery and lower revision rates before and after initiation of the VBP program. Robotic arm-based TKA was superior to manual total knee arthroplasty, with an increased effectiveness of 0.26 (16.87 vs 16.61) before and 0.52 (16.96 vs 16.43) after the application of Volume-based procurement, respectively. The procedure is more cost-effective in the new procurement system (17.13 vs 16.89). Costs of manual or robotic arm-assisted TKA were the most sensitive parameters in our model.<BR><B>CONCLUSIONS: </B>Based on previous and current medical charging systems in China, robotic arm-assisted total knee arthroplasty is a more cost-effective procedure compared to traditional manual total knee arthroplasty. As the volume-based procurement VBP program shows, the procedure can be more cost-effective.