Economics and Reimbursement for Spine Technologies

This chapter discusses health economics and cost analyses in the context of evaluation of spine technologies. There are three principal methods for evaluating the cost-effectiveness (that is, costs and outcomes) of an intervention: prospective studies, database analysis, and modeling. Often, these methods are used in combination to provide complete information on cost-effectiveness. Prospective evaluation of cost-effectiveness can be performed in two settings. First, the costs and benefits of a therapy can be evaluated as part of a clinical trial. Cost-effectiveness can also be evaluated in prospective “naturalistic” studies. Databases used for cost-effectiveness analyses can include medical claims from public or private insurance providers, or databases from registries, health surveys, or other naturalistic prospective studies. Each data source has advantages and disadvantages, which are outlined in the chapter. Additional research needs to be conducted into the cost of other related conditions, to justify the costs associated with preventive and therapeutic technologies.