An economic analysis of using rhBMP-2 for lumbar fusion in Germany, France and UK from a societal perspective.

Recombinant human Bone Morphogenetic Protein-2 (rhBMP-2) can replace autogenous bone grafting in single-level lumbar interbody fusion. Its use is associated with a higher initial price for the intervention; 2,970 euros in Germany, 2,950 euros in France and 2,266 euros (1,790 pounds sterling) in UK. The aim of this study was to calculate the financial impact of rhBMP-2 treatment in Germany, UK and France from a societal perspective with a two-year time horizon. Based on clinical findings of a previously published study with a pooled data analysis, a health economic model was developed to estimate potential cost savings derived from reduced surgery time and secondary treatment costs, and faster return-to-work time associated with rhBMP-2 use compared with autogenous bone grafting. Country-specific costs are reported in 2008 Euros. From a societal perspective, overall savings from the use of rhBMP-2 in ALIF surgery compared with autograft are 8,483 euros, 9,191 euros and 8,783 euros per case for Germany, France and UK, respectively. In all the three countries savings offset the upfront price for rhBMP-2. The savings are mainly achieved by reduced productivity loss due to faster return-to-work time for patients treated with rhBMP-2. Use of rhBMP-2 in anterior lumbar fusion is a net cost-saving treatment from a societal perspective for Germany, France and UK. Improved clinical outcome for the patient combined with better health-economic outcome for the society support rhBMP-2 as a valuable alternative compared with autograft.