Health economics: A cost analysis of treatment of persistent fracture non-unions using bone morphogenetic protein-7

Objective: To compare the cost implications of treatment of persistent fracture non-unions before and after application of recombinant human bone morphogenetic protein-7 (BMP-7). Method: Of 25 fracture non-unions, 9 were treated using BMP-7 alone and 16 using BMP-7 and bone grafting. These patients were prospectively followed up, and the costs incurred were analysed. Results: The mean number of procedures per fracture performed before application of BMP-7 was 4.16, versus 1.2 thereafter. Mean hospital stay and cost of treatment per fracture before receiving BMP-7 were 26.84 days and 13,844.68 pound, versus 7.8 days and 7338.4 pound thereafter. The overall cost of treatment of persistent fracture non-unions with BMP-7 was 47.0% Less than that of the numerous previous unsuccessful treatments (p = 0.001). Conclusions: Treating fracture non-unions is costly, but this could be reduced by early BMP-7 administration when a complex or persistent fracture non-union is present or anticipated. (C) 2006 Elsevier Ltd. All rights reserved.