Growing evidence suggests that individuals with transfemoral amputations or knee disarticulations using a prosthesis equipped with a microprocessor-controlled knee (MPK) can benefit from enhanced mobility and safety, including fewer falls. In elderly individuals, high mortality rates are assumed to reduce the expected useful life of MPKs, which raises concerns regarding their economic effectiveness.
From a Swedish payer’s perspective, the objective was to investigate the cost-effectiveness and budget impact of the Kenevo/MPK (Ottobock, Duderstadt, Germany) compared with non–microprocessor-controlled knees (NMPKs) in people older than 65 years at the time of their transfemoral amputation or knee disarticulation. Researchers developed a decision-analytic model to conduct the economic analysis of the Kenevo/MPK, and model parameters were derived from Swedish databases and published literature.
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 (about $12,000) per quality-adjusted life year. The probability of the MPK being cost-effective at a threshold of EUR40,000 (about $42,201) per quality-adjusted life year was 99 percent. The five-year budget impact model predicted an increase in payer expenditure of EUR1.76 million (about $1.86 million) if all new patients received a Kenevo/MPK, and 50 percent of current NMPK users switched to the MPK.
Results of the modeling suggested that the Kenevo/MPK is likely to be more cost-effective for elderly individuals, primarily because of a reduction in falls.
The study “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” was published in the journal Prosthetics and Orthotics International.