OBJECTIVES: To determine the budget impact if knee orthoses were funded for patients with severe osteoarthritis (OA) of the knee from a private Australian payer perspective.

METHODS: The ISPOR Principles of Good Practice were used to guide a budget impact analysis comparing the use of knee orthoses to delay total knee reconstruction (TKR) versus the current environment. Delayed TKR was estimated based on a systematic review of electronic databases and a web-based search. Utilisation for TKR (sourced from Australian Medical Benefits Schedule statistics) was projected over the time horizon (2023 to 2027). The clinically eligible (i.e., target) population was based on the proportion of patients with OA of the knee in a large US cohort (N=8,002) deemed to have had TKR prematurely. The cost of TKR was based on Australian hospital separation data.

RESULTS: Funding of knee orthoses was associated with a cost-saving of $AUD122 to $AUD126 million over a 5-year time horizon based on device costs of $AUD500 and $AUD395, respectively. The cost-savings were primarily driven by 18,000 delayed TKR procedures. Knee orthosis, such as the Thuasne OA, were also associated with improvements in clinical outcomes including pain-free walk distance, pain during exercise, and lequesne index score (P<0.005).

CONCLUSIONS: The widespread prevalence of COVID-19 has disrupted the capacity for Australian hospitals to undertake elective surgeries. The median wait-list time for TKR, which accounted for 47,000 surgeries in 2020-2021, increased from 223 to 308 days in Australia between 2019-2020 to 2020-2021. Our research indicates that the funding of appropriate knee orthoses in patients with severe OA has a cost-saving budget impact while offering potential clinical improvement for patients and reduced pressure on elective surgery wait lists.