Cost-Effectiveness Analyses of Bone Morphogenetic Protein 2 (rhBMP-2) in Spinal Fusion: A Systematic Review.

Study design: Systematic Review Study.

Objectives: The objective of this study is to assess the cost-effectiveness and cost-utility of rhBMP-2 in spine surgeries.

Methods: PubMed, MEDLINE, OVID and CENTRAL (Cochrane Central Register of Controlled Trials) databases were systematically searched for studies reporting the use of rhBMP-2 for spinal procedures in comparison to autograft and/or allograft and alternative graft materials under consideration of cost-effectiveness, cost-benefit, cost minimization, and/or cost-utility analysis. Relevant data points were extracted and compiled. The standardization of the selected studies was graded using the CHEERS criteria.

Results: Of the 88 eligible publications, 17 met the inclusion criteria. Overall, 8 studies showed a favorable cost-analysis profile. Three studies performed cost-consequence analyses, none of which reported positive findings. Among 7 cost-utility analyses and 7 cost-effectiveness analyses, 3 and 5, respectively, reported a likely benefit to the usage of rhBMP-2. The CHEERS scores for the included studies ranged from 15 to 23 out of 24 points, with a median score of 19.

Conclusions: There is no consensus regarding the cost-effectiveness or cost-utility of rhBMP-2 in spinal fusion. rhBMP-2 may function as a cost-effective adjunct in spinal fusion surgeries in select cases.