(F1226) PSEUDO-COST-EFFECTIVENESS ANALYSIS OF AUTOLOGOUS ADIPOSE-DERIVED MESENCHYMAL STEM CELL THERAPY FOR K/L 3&4 PATIENTS WITH KNEE OSTEOARTHRITIS COMPARED TO TOTAL KNEE ARTHROPLASTY

Abstract: Knee osteoarthritis (KOA) is characterized by progressive cartilage degeneration, often driven by aging and mechanical stress, and results in pain and functional impairment. Although adipose-derived mesenchymal stem cells (ASCs) have emerged as a potential KOA treatment, they are costly and exhibit cellular heterogeneity that can affect efficacy. Moreover, there is insufficient evidence to determine whether ASCs are superior to existing therapies.
This study developed a novel patient-level economic model, incorporating individual patient attributes, to examine whether ASCs are more cost-effective than total knee arthroplasty (TKA), the gold standard for severe KOA, within a relatively short timeframe. Knee Injury and Osteoarthritis Outcome Score, Visual Analogue Scale and Timed Up & Go Test were used as outcome measures. This study conducted scenario analyses under different reimbursement structures, demand estimation and preferences, and cost assumptions to account for the uncertainty in future health care policies.
In a scenario where ASCs and TKA operate under the same reimbursement system, occupy equal portions of the market, and apply different markup rates, ASCs prove to be cost-effectively dominant over short periods (1, 3, and 6 months). In a scenario where the reimbursement system for ASCs differs significantly from that for TKA—yet both hold equal market shares and apply different markup rates—TKA is cost-effectively dominant, whereas ASCs are dominated over the same short-term intervals. In the most realistic scenario, where reimbursement systems, market shares, and markup rates all differ between ASCs and TKA, insufficient long-term evidence remains to determine whether ASCs are more cost-effective than TKA. Results from additional scenarios—such as those involving demand estimation, patient preferences, and cost assumptions—will be presented in full at the conference.
In summary, this study is the first to develop a novel, individual-level model for cell therapy from an economic perspective. It aims to contribute to optimal treatment for severe KOA patients while emphasizing that patient cooperation in data collection is essential for verifying long-term cost-effectiveness.

Funding Source: This work was supported by JST SPRING, Grant Number JPMJSP2123.

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