An economic model to estimate the relative costs over 20 years of different hip prostheses

Study ojective-To determine the relative costs of prostheses and factors as sociated with changes in these cost rankings. Design and setting-Economic model using published data. Main results-The main cost drivers are current costs and revision rates. Ex pected revision costs are a small proportion of the expected total costs. T here are few competitors to the "gold standard" Charnley in terms of total expected costs over 20 years. There is no monetary advantage in using highe r cost prostheses in older patients even if they were to have lower revisio n rates. There may be a monetary case for using prostheses with higher cost s and lower revision rates in younger patients. Conclusions-The most cost effective prosthesis in older patients is the Sta nmore. The Charnley, Exeter Polished and Muller Straight Stem are marginall y more costly than the Stanmore. The study inevitably lacks good data on su rvival for newer prostheses. This does not affect the ability to make choic es fur older patients. Data are needed, however, on survival of cemented pr ostheses for younger patients.