The economic burden in terms of cost of illness and generic health-related quality of life of posttraumatic long bone non-unions among the adult population of the Netherlands from a societal perspective

Introduction. This cost of illness study aimed to assess the economic burden of posttraumatic long bone non-unions in the Netherlands from a societal perspective by evaluating the costs and health-related quality of life (HRQoL).

Material & Methods. The incidence-based bottom-up approach was applied in the cost of illness analysis. The target population was adult patients with posttraumatic long bone non-unions. The healthcare costs, patient and family costs, and productivity losses were considered in the study. The valuation of the costs was based on the Dutch costing guidelines. For the valuation of productivity losses, the friction cost method was applied. The EQ-5D-5L questionnaire was used to measure the HRQoL. The patients completed the questionnaires at their initial visit to Maastricht University Medical Center (MUMC+). In the deterministic one-way sensitivity analysis the baseline patient characteristics varied within 10% was used. Additionally, a scenario analysis was performed from healthcare and patient perspectives and for subgroups of the patients.

Results. The healthcare costs, patient and family costs, productivity losses, and the overall costs of the posttraumatic long bone non-unions were estimated at €5,565, €1,335, €6,699, and €13,599, respectively, per patient for three months before the initial visit at the non-union clinic. The variation of the baseline patient characteristics within 10% had little effect on sensitivity analysis confirming the robustness of the base case study results. Meanwhile, the subgroup analysis showed significant differences in total costs between the male and female cohorts - €16,069 and €9,318, respectively. No significant differences in HRQoL were observed between the subgroups.

Conclusion. The burden of posttraumatic long bone non-unions was shown to be considerable for Dutch society in monetary terms and HRQoL, emphasize the need for effective preventative and therapeutic strategies.

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