Evidence map›Paper›PMID 39623243›Full record

ArticlePharmacoEconomics - open2025

Economic Evaluation of Total Knee Replacement Compared with Non-Surgical Management for Knee Osteoarthritis in India.

Amatullah Sana Qadeer, Ananda Meher, Jennifer Rachel, Winnie Paulson, Abhilash Patra, Naline Gandhi, Nirupama Ay, Lipika Nanda, Sarit Kumar Rout, Ambarish Dutta

Abstract read
In one paragraph

Article in PharmacoEconomics - open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Amatullah Sana Qadeer *Indian Institute of Public Health-Hyderabad, Institute of Public Health Sciences, Hyderabad, India.
Ananda Meher *Kalinga Institute of Industrial Technology University, Bhubaneswar, Odisha, India.
Jennifer RachelIndian Institute of Public Health-Hyderabad, Institute of Public Health Sciences, Hyderabad, India.
Winnie PaulsonIndian Institute of Public Health-Hyderabad, Institute of Public Health Sciences, Hyderabad, India.
Abhilash PatraIndian Institute of Public Health-Hyderabad, Institute of Public Health Sciences, Hyderabad, India.
Naline GandhiDuke-NUS Medical School, 8, College Road, Singapore, Singapore.
Nirupama AyIndian Institute of Public Health-Hyderabad, Institute of Public Health Sciences, Hyderabad, India.
Lipika NandaIndian Institute of Public Health-Hyderabad, Institute of Public Health Sciences, Hyderabad, India.
Sarit Kumar RoutIndian Institute of Public Health-Bhubaneswar, Public Health Foundation of India, Plot No: 267/3408, Jaydev Vihar, Mayfair Lagoon Road, Bhubaneswar, Odisha, 751013, India.
Ambarish DuttaIndian Institute of Public Health-Bhubaneswar, Public Health Foundation of India, Plot No: 267/3408, Jaydev Vihar, Mayfair Lagoon Road, Bhubaneswar, Odisha, 751013, India. ambarish.dutta@iiphb.org.ORCID http://orcid.org/0000-0002-4019-7472

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study is an economic evaluation of total knee replacement (TKR) in comparison with non-surgical management in India.

methodsCost-utility analysis and budget impact analysis (BIA) were conducted on individuals aged ≥ 50 years with osteoarthritis of the knee (OA knee) Kellgren-Lawrence grades 2 and 3 using a provider's perspective. Three scenarios were considered, varying the age at which TKR is administered while assuming a 20-year lifespan for the implant. A Markov model was used to determine incremental cost-effectiveness ratios (ICERs). Sensitivity analysis was conducted incorporating implant costs and other input parameters.

resultsNet quality-adjusted life-years (QALYs) gained per OA knee treated with TKR were superior when performed at the age of 50, regardless of OA severity and across all scenarios. The lowest ICER was 36,107 Indian National Rupees (INR) (USD 482.9)/QALY gained, observed at 50 years, while the highest was INR 61,363 (USD 820.72)/QALY gained at 70 years for grade-2 severity. Sensitivity analysis revealed that the ICER was most sensitive to the cost of non-surgical management, health utility values gained in an improved state, and the cost of TKR across scenarios. For the BIA in Scenario 1, with 40% coverage for TKR, costs reach INR 5013 crores (cr) (USD 670,477,060) in 2023 and INR 8444 cr (USD 1,024,628,736) in 2028 (1% of government budgets). In Scenario 2 (full coverage), costs are INR 12,532 cr (USD 1,520,683,008) (2.7%) in 2023, declining to 2.4% in 2028. In Scenario 3, covering 40% under the National Health Mission (NHM), costs vary from 17% in 2023 to 25% in 2028.

conclusionThis study concludes that TKR is a cost-effective treatment option compared with non-surgical management for OA knee in India, irrespective of age, implant types, and severity.

Identifiers

PMID39623243
PMCPMC11865410

What Socratic holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.