Supporting Innovations that Require Complex Implementation

MATCH has been testing whether it is viable for hospitals to combine innovations from two separate companies to provide computer-assisted knee replacement surgery.

The Markov modelling examines in which cases better outcomes justify buying the costly extra equipment required. First it studies the benefits of surgery with minor complications, compared with major complications. It then examines in what circumstances, and to what extent, computer-assisted surgery is likely to be more successful.

The modelling by Dr Henglin Dong and Professor Martin Buxton from Brunel University has helped the two companies considerably to examine the potential of what is a £100M a year global market. DePuy International, one of the MATCH research partners, sells hip and knee replacements. It has been developing an implant to work with an alignment system, marketed by a commercial partner, BrainLAB.

As a result of the work, the companies can now run the model with customers across the UK, France, Germany, Switzerland and South Africa to assess the suitability of the combined technologies for circumstances in those particular countries.

The collaborative development through MATCH of a Markov model to calculate the potential health economic value of Computer Assisted Surgery in knee joint replacement has been of great value to the business. The publication is a widely quoted key reference in the literature. The results from the model are being integrated into a provider proposition tool which sales people will use to help hospitals to understand the economic proposition of adoption of this technology. Alan Ashby, Vice President, Global Concept Development, DePuy International

The Project

The global market for knee implants using computer assisted surgery (CAS) is worth about £100M a year. However, its sales route is complicated and indirect. DePuy International sells knee implants, but not the computer-based system, which has been developed and is marketed by its commercial partner, BrainLAB. The computer system is also expensive - and hospitals are reluctant to pay for it. So the two companies have to enter into a dialogue to persuade customers that the investment is worthwhile.

That’s why the companies asked MATCH to develop a Markov model showing the likely benefits in terms of outcomes of computer assisted surgery. The initial research was done by Dr Henglin Dong and Professor Martin Buxton at Brunel University, but they travelled to Germany to support the handover.

Working with MATCH academics has challenged some of our assumptions and internal processes particularly on the early identification and validation of a product's value to payer and provider stakeholders. Mick Borroff, Clinical and Reimbursement Lead for DePuy International

The global market for knee implants using computer assisted surgery (CAS) is worth about £100M a year. However, its sales route is complicated and indirect. DePuy International sells knee implants, but not the computer-based system, which has been developed and is marketed by its commercial partner, BrainLAB. The computer system is also expensive and hospitals are reluctant to pay for it. So the two companies have to enter into a dialogue to persuade customers that the investment is worthwhile.

That’s why the companies asked MATCH to develop a Markov model showing the likely benefits in terms of outcomes of computer assisted surgery. The initial research was done by Dr Henglin Dong and Professor Martin Buxton at Brunel University, but they travelled to Germany to support the handover.

DePuy has now embedded the model in its thinking. It has spent about £50,000 producing an interactive spreadsheet that can test the equipment against local data, using evidence from papers showing the economic case. The company has trained 5-6 people to use the tool. They can take the dialogue to surgeons and hospital managers in the key potential markets.

Dr Thorsten Burger, DePuy’s commercial and technical manager for computer-assisted surgery, said: "The model enables us to move the discussion around CAS from purely being seen as a cost factor for the providers/payers to a value-based discussion."

Next steps

The modelling is ongoing. It will take several years to understand the full story of computer assisted surgery. More will be known once the 5-year survival figures are available.

Further Information

 

Elizabeth Deadmanmatch@brunel.ac.uk