Lifetime cost-effectiveness of hallux valgus correction surgery using patient-reported outcomes from the National British Orthopaedic Foot and Ankle Registry in the United Kingdom.
Open hallux valgus correction costs just £8737 per quality-adjusted life year gained.
Lifetime cost-effectiveness of hallux valgus correction surgery using patient-reported outcomes from the National British Orthopaedic Foot and Ankle Registry in the United Kingdom.
Hallux valgus is the most prevalent forefoot condition and is associated with substantial pain, functional impairment and reduced health-related quality of life.
A cost-utility analysis was performed from the perspective of the UK National Health Service (National Health Service) using British Orthopaedic Foot and Ankle Society (British Orthopaedic Foot and Ankle Society) Registry data for adults undergoing primary hallux valgus correction by osteotomy (open or minimally invasive surgery, MIS).
From 1111 registry pathways, 306 patients had complete EQ-5D-5L datasets for cost-utility modelling, comprising 129 open and 177 MIS procedures.
EQ-5D-5L utility improved from 0.69 (95% CI 0.65-0.72) at baseline to 0.84 (95% CI 0.81-0.88) at 12 months in the open group, and from 0.69 (95% CI 0.66-0.72) to 0.82 (95% CI 0.79-0.84) in the MIS group (both p < 0.001).
In sensitivity analysis using incremental costs against conservative management, the incremental cost-effectiveness ratios ranged from cost-saving (-£374 per quality-adjusted life year) to £ 3219 per quality-adjusted life year across all tested scenarios.
Hallux valgus correction surgery is highly cost-effective from the UK National Health Service perspective, with cost per quality-adjusted life year values substantially below those reported for total hip and total knee arthroplasty.
The current restriction of access in some UK regions is not supported by national health-economic evidence. LEVEL OF EVIDENCE: III (economic and decision analysis based on prospective registry data).