Cost Effectiveness of Allogeneic Umbilical Cord Blood-Derived Mesenchymal Stem Cells in Patients with Knee Osteoarthritis

Kangho Suh (), Brian J. Cole, Andreas Gomoll, Seung-Mi Lee, Hangseok Choi, Chul-Won Ha, Hong Chul Lim, Myung Ku Kim, Gwi-Yeom Ha and Dong-Churl Suh
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Kangho Suh: University of Pittsburgh School of Pharmacy
Brian J. Cole: Rush Medical College
Andreas Gomoll: Weill-Cornell Medical College
Seung-Mi Lee: Daegu Catholic University College of Pharmacy
Hangseok Choi: Chung-Ang University College of Pharmacy
Chul-Won Ha: Sungkwunkwan University Samsung Seoul Hospital
Hong Chul Lim: Seoul Baronsesang Hospital
Myung Ku Kim: Inha University School of Medicine
Gwi-Yeom Ha: Chung-Ang University College of Pharmacy
Dong-Churl Suh: Chung-Ang University College of Pharmacy

Applied Health Economics and Health Policy, 2023, vol. 21, issue 1, No 13, 152 pages

Abstract: Abstract Objectives The aim of this study was to assess the cost effectiveness of allogeneic umbilical cord blood-derived mesenchymal stem cells with sodium hyaluronate (hUCB-MSC) compared with microfracture in patients with knee cartilage defects caused by osteoarthritis (OA) in South Korea. Methods A partitioned survival model approach was taken consisting of five mutually exclusive health states: excellent, good, fair, poor, and death over a 20-year time horizon. Utility values were obtained from a randomized clinical trial. Cost data were extracted from a database provided by the Health Insurance Review & Assessment Service, and the utilization of healthcare services was estimated from an expert panel of orthopedic surgeons using a structured questionnaire. The incremental cost-effectiveness ratio (ICER) in terms of quality-adjusted life-years (QALY) was calculated. Deterministic and probabilistic sensitivity analyses were performed. Results In the base case, the incremental costs of US$14,410 for hUCB-MSC therapy along with its associated QALY gain of 0.857 resulted in an ICER of US$16,812 (₩18,790,773) per QALY (95% confidence interval [CI] US$13,408–US$20,828) when compared with microfracture treatment from a healthcare payer perspective. From a societal perspective, the ICER was US$268 (₩299,255) per QALY (95% CI −US$2915 to US$3784). When using a willingness-to-pay threshold of US$22,367/QALY, the probability of hUCB being cost effectiveness compared with microfracture was 99% from the healthcare payer perspective and 100% from the societal perspective. Conclusions The study demonstrated that hUCB-MSC therapy was cost effective compared with microfracture when treating patients with knee OA. These findings should inform health policy decision makers about considerations for cost-effective therapy for treating knee OA to ultimately enhance population health.

Date: 2023
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DOI: 10.1007/s40258-022-00762-9

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