Objectives: Damaged rotator cuff tendons are one of the leading causes of shoulder-related disability. Resorbable Bioinductive Implant* (RBI) has been found to be safe and effective in the surgical treatment of full-thickness rotator cuff tears (FT RCT). This study aimed to assess the cost-effectiveness of RBI + standard care (SC) compared to SC alone defined as arthroscopic repair with double row repair in the treatment of FT RCT.

Methods: We developed a decision analytic model to compare the expected incremental cost and clinical consequences for a cohort of patients treated with RBI + standard care compared with SC alone following surgery FT RCT. The transition probabilities for healed (retorn), was estimated from published REBUILD shoulder Registry studies and a meta-analysis, stratified by tear size. Implant and healthcare costs were estimated from a payer’s perspective in 2021 US prices. We conducted a probabilistic sensitivity analysis.

Results: The base case analysis considered all tears together, demonstrated that RBI as an adjunct to SC results in incremental costs of $2,766 and an additional 0.11 healed RCTs. The estimated incremental cost-effectiveness ratio (ICER) is $25,594/healed RCT compared to SC alone. Cost-effectiveness improved with tear size with biggest benefit seen in massive tears compared to large or medium full thickness tears. The estimated ICERs for the different tear sizes were $4,275, $18,555, and $31,451per healed RCT respectively. When used a societal perspective, (factored return to work), RBI became cost-saving. The probability that RBI is cost-effective is 97% compared to SC.

Conclusions: RBI + SC is a cost-effective compared to SC alone in managing FT RCT. The results are sensitive to tear type and the perspective of the analysis. Long term comparative data is needed to confirm if these benefits persist over a longer time horizon.

*REGENETEN Bioinductive Implant. Smith+Nephew, Inc. Andover, MA