Title

Cost-Effectiveness of Magnetically Controlled Growing Rods: Who Really Benefits?

Document Type

Journal Article

Publication Date

5-1-2019

Journal

Spine Deformity

Volume

7

Issue

3

DOI

10.1016/j.jspd.2018.09.066

Keywords

Cost analysis; Early-onset scoliosis; Magnetic growing rods; Traditional growing rods

Abstract

© 2018 Scoliosis Research Society Study Design: Retrospective case analysis. Objectives: Evaluate the cost difference between magnetically controlled growing rod (MCGR) and traditional growing rod (TGR) surgeries at initial implantation and determine the recipient of cost savings. Summary of Background Data: Treatment of early-onset scoliosis is challenging and costly, with growing rods (GRs) becoming a standard treatment. Although both effectively control deformity, TGR requires repeat surgical lengthening and MCGR does not. Previous cost analyses have suggested that MCGR results in lower overall cost after 3 years because of the elimination of repeat surgeries; however, the benefactor of these savings is unclear. Methods: All patients who underwent initial GR implantation from May 2011 to January 2016 at a tertiary care children's hospital were included (37 cases: 16 MCGR and 21 TGR; 4 TGR to MCGR conversions). Financial information was analyzed including insurance provider, and amount billed to and reimbursed from payer. Charges at the time of implantation were divided into categories (surgery time, room/board, anesthesia, implant cost, lab, radiology, therapy, medications, neuromonitoring, operating room materials, and recovery room). Variables were compared using t-tests to determine differences overall and per category. Results: The average overall charge for MCGR implantation was 1.5 times greater than TGR implementation (p = .04). Average charges were statistically similar across all categories, except implant costs, which were significantly higher for MCGR (MCGR: $31,621 vs. TGR: $8,966, p < .0001). The average percentage reimbursement of total charges were similar between surgeries (MCGR 43% vs. TGR 46%, p = .26). Conclusions: MCGR implantation has a significantly higher charge than TGR, secondary to the higher expense of MCGR implants. Despite this, total institutional reimbursement is similar between the two procedures. Although MCGRs have been shown to be “cost effective” after 3 years, our findings suggest health care institutions bear the cost of this new technology while payers gain the long-term financial benefit. Level of Evidence: Level III, economic analysis.

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