A Cost-Utility Analysis of Robotic Arm-Assisted Total Hip Arthroplasty: Using Robotic Data from the Private Sector and Manual Data from the National Health Service

Table 5

Health economic analysis for lifetime cost per QALY for manual total hip arthroplasty (mTHA) and robotic arm-assisted total hip arthroplasty (rTHA).

Health economic analysis
Utility
Mean (SD) health evaluation
mTHA preoperative	0.384 (0.320)
mTHA postoperative	0.754 (0.263)
mTHA mean difference (95% CI)	0.370 (0.340 to 0.400)
rTHA uplift (Table 4)	0.091
Mortality
10-year mortality rate	25%
Remaining life expectancy of a 69-year-old patient	17 years
Financial costs
Cost of mTHA (NHS tariff)	£6,207
Additional costs of rTHA
Robot (based on 100 per year)	£1,152
Consumables	£278
CT scan	£86
Total per patient	£1516
Rate and cost of revision
Annual revision rate	0.389%
Revision costs
Aseptic (87% cases)	£11,897
Septic (13% cases)	£21,937
QALYs gained
10-year QALY gain
Undiscounted	0.7935
Discounted (5%)	0.6453
Lifetime QALY gain
Undiscounted	1.5470
Discounted (5%)	1.0590
Cost per QALY
10-year horizon
Undiscounted	£1,910
Discounted	£2,349
Lifetime horizon
Undiscounted	£980
Discounted	£1,432

Paired t-test, accounts for revision rate and mortality.