Cost-effectiveness of percutaneous fixation with Kirschner wires versus locking-plate for adult patients with a dorsally displaced fracture of the distal radius from the DRAFFT trial

Background: Over four millions people in England are estimated to have a CVD and they are responsible for over one third of deaths and a fifth of hospital admissions in England every year. In prioritising the reduction of premature mortality there has been a focus on improving prevention and early diagnosis and in 2009 the Department of Health implemented the NHS Health Checks (HC) policy. In the past years, the prescriptions of statins have increased and it is interesting to see whether these increases have continued or intensified with changes in CVD detection. The cost-effectiveness analysis (cost per QALY) was derived from a multi-centre, two-arm, parallel group, assessor-blind randomised controlled trial which took place in 18 trauma centres in the UK. Resource use data were received from 460 patients; only one patient did not provide any resource use data. The analysis includes both the Health Service perspective ¨C cost of surgery, implants, physiotherapy etc ¨C and the societal perspective - cost of time off work and private care. There was small difference in health-related quality of life (QALYs gain) for patients treated with locking-plate versus K-wire fixation. At an additional cost of ¡ê714, locking-plate fixation presented an incremental cost-effectiveness ratio of ¡ê89,322 per QALY within the first 12 months of treatment. A number of sensitivity analyses were undertaken, but the incremental costeffectiveness ratios of locking-plates fixation compared with K-wires were always more than ¡ê30,000. The economic evaluation is driven by the choice of fixation; K-wire fixation is a ¡®cost saving¡¯ intervention being substantially less expensive than locking-plate fixation.