Expertise in health economics analysis at the AO ITC

Health economics research evaluates the value, cost, and impact of interventions and treatment strategies. Given the recent and rapid emergence of innovative technologies (eg, robotic surgery, endoscopic procedures, biologics, etc), economic analyses can help justify the adoption of innovations by demonstrating their long-term value. The AO Innovation Translation Center (AO ITC) has experience and expertise in delivering such research and is currently expanding and applying it across its studies.

“Most health care systems around the world are facing significant financial pressures,” said Alexander Joeris, Head of Medical Scientific Affairs at the AO ITC. “As a result, it is no longer enough to focus solely on clinical outcomes; these outcomes must now also be assessed in relation to the resources required to achieve them. This approach applies to both existing and new technologies and treatments.”

One recent example of health economics research supported by the AO ITC is the AO Spine Knowledge Forum Trauma & Infection’s TLA3-A4 study on thoracolumbar burst fractures.

Its primary objective was to assess whether surgically treated AO Spine A3/A4 fractures lead to a more rapid improvement of patient disability as measured on the Oswestry Disability Index (ODI) within twelve months of the beginning of treatment. The study concluded that there was no difference between surgically and conservatively treated patients—both patient groups did well.

Health economics is going to be an indisputable part of clinical research in the future.


Alexander Joeris, Head of Medical Scientific Affairs at the AO ITC

However, the study data was also used to perform a separate cost-utility analysis designed to compare the economic and social benefits of surgical and non-surgical treatment options at a global level.

This study was executed with support from the AO ITC and considered the direct and indirect costs of treatment. It was based on clinical data, patient diaries, peer-reviewed literature, and international healthcare cost guidelines and databases. The results show that, when considering the cost/benefit to the patient and society, surgical management provides improved outcomes at lower cost in comparison to non-operative treatment. The main reason is a greater loss of productivity within the nonsurgical group—both among patients and caregivers.

Within the first year after treatment, surgery was not considered to be more cost-effective than non-surgical treatment. However, after two years, non-surgical patients had recorded more frequent visits to surgeons, general practitioners, physiotherapists, and other health professionals. They also had a higher reliance on pain killers and opioids, averaged more lost workdays, and caused caregivers to take significantly more time off work.

This cost-utility analysis was presented at multiple national and international conferences and has been recognized with several awards.

Alexander Joeris underscored the importance of such analyses for the future: “Health economics is going to be an indisputable part of clinical research in the future. With a global network of surgeon leaders in trauma and musculoskeletal diseases, the AO has the unique opportunity to conduct high quality economic analysis. The AO ITC is committed to support more activities in this direction in the future.”

Additional health economics research studies published by the AO ITC:

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