TRANSARTERIAL PERIARTICULAR EMBOLIZATION (TAPE) AS A MINIMALLY INVASIVE AMBULATORY CARE STRATEGY TO OPTIMISE HEALTHCARE EXPENDITURE IN ADVANCED KNEE OSTEOARTHRITIS TREATMENT
Author(s)
Viktor Makowski, MBA1, Claudia Widloecher, Mrs.2, Aline Topouchian, PhD3.
1Market Access Manager, Terumo Deutschland GmbH, Eschborn, Germany, 2Terumo Deutschland GmbH, Eschborn, Germany, 3Terumo Interventional Systems, Leuven, Belgium.
1Market Access Manager, Terumo Deutschland GmbH, Eschborn, Germany, 2Terumo Deutschland GmbH, Eschborn, Germany, 3Terumo Interventional Systems, Leuven, Belgium.
OBJECTIVES: Transarterial periarticular embolization (TAPE) is a minimally invasive option for patients with inadequate response to conservative therapies. This study evaluates the economic impact of TAPE in patients with an indication for surgical Total Knee Arthroplasty (TKA).
METHODS: A deterministic budget impact model was developed from the German statutory health insurance (SHI) perspective over a 10-year horizon for a cohort of 100 patients. In the standard pathway, all patients received TKA. A TAPE uptake of 70% was assumed, reflecting a plausible proportion of patients treated prior to TKA, with the remaining 30% proceeding to TKA. A decision-tree approach was applied to TAPE-treated patients to model subsequent TKA utilization. Patients were categorized as non-responders (30%), moderate (45%), and strong responders (25%), with non-responders and 25% of moderate responders undergoing TKA. Repeated TAPE treatments were included (mean 2.6; maximum six). Costs were based on German DRG reimbursement tariffs from the SHI perspective. Scenario analyses applied reduced TKA conversion (~20%) among TAPE-treated patients. Sensitivity analyses assessed retreatment and reintervention rates.
RESULTS: In the base case, introducing TAPE into the pathway delayed and reduced TKA procedures from 100 to ~59 per 100 patients (-41%). TAPE costs (~€420,000) were offset by avoided TKA costs (>€450,000) (-9%). With reduced (~20%) TKA conversion scenario, TKA procedures decreased to ~44 per 100 patients, increasing opportunity costs by ≥€200,000. Savings were maintained up to a breakeven point of 3 procedures per patient declining with a higher retreatment. Results were sensitive to TKA reintervention rates, with greater savings under higher long-term assumptions (7-15%).
CONCLUSIONS: Incorporating TAPE prior to TKA delays procedures and avoids unnecessary expenditures for surgery. Economics benefit is driven by reduction of avoidable TKA. Even under conservative assumptions the use of TAPE would be an alternative strategy to optimize healthcare resource use in advanced knee osteoarthritis in Germany.
METHODS: A deterministic budget impact model was developed from the German statutory health insurance (SHI) perspective over a 10-year horizon for a cohort of 100 patients. In the standard pathway, all patients received TKA. A TAPE uptake of 70% was assumed, reflecting a plausible proportion of patients treated prior to TKA, with the remaining 30% proceeding to TKA. A decision-tree approach was applied to TAPE-treated patients to model subsequent TKA utilization. Patients were categorized as non-responders (30%), moderate (45%), and strong responders (25%), with non-responders and 25% of moderate responders undergoing TKA. Repeated TAPE treatments were included (mean 2.6; maximum six). Costs were based on German DRG reimbursement tariffs from the SHI perspective. Scenario analyses applied reduced TKA conversion (~20%) among TAPE-treated patients. Sensitivity analyses assessed retreatment and reintervention rates.
RESULTS: In the base case, introducing TAPE into the pathway delayed and reduced TKA procedures from 100 to ~59 per 100 patients (-41%). TAPE costs (~€420,000) were offset by avoided TKA costs (>€450,000) (-9%). With reduced (~20%) TKA conversion scenario, TKA procedures decreased to ~44 per 100 patients, increasing opportunity costs by ≥€200,000. Savings were maintained up to a breakeven point of 3 procedures per patient declining with a higher retreatment. Results were sensitive to TKA reintervention rates, with greater savings under higher long-term assumptions (7-15%).
CONCLUSIONS: Incorporating TAPE prior to TKA delays procedures and avoids unnecessary expenditures for surgery. Economics benefit is driven by reduction of avoidable TKA. Even under conservative assumptions the use of TAPE would be an alternative strategy to optimize healthcare resource use in advanced knee osteoarthritis in Germany.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE659
Topic
Economic Evaluation, Medical Technologies
Topic Subcategory
Budget Impact Analysis
Disease
Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), Surgery, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)