With changes in health care physicians are increasingly being scrutinized for the care they administer including rotator cuff repair. More and more we are required to ask ourselves whether a procedure or medicine is cost-effective, that is does it produce a result medically and does it come at a reasonable cost.
As a shoulder specialist, one of the most common procedures I perform is an arthroscopic rotator cuff repair. There is no question that in the right setting (correct indication and well-done procedure) an arthroscopic rotator cuff repair leads to substantial improvement in function and reduction in pain. But the economic impact or cost-effectiveness of this procedure has been less well studied. In the November 2013 issue of The Journal of Bone and Joint Surgery a study by Mather et al. reported on the societal and economic value of rotator cuff repair (Link to Article). Interestingly, despite the increased up-front cost of surgery they found that rotator cuff repair saved society approximately $14,000 over a patient’s lifetime. For a patient between the ages of 30 and 39, a rotator cuff repair saved society about $78,000, whereas a rotator cuff repair in a patient between 70 and 79 costs society about $12,000.
A rotator cuff repair saves money in young patients because it allows more predictable return to work. On the other hand, as expected for older patients who are not working there is net cost to society since the procedure costs money but does not necessarily result in return to work. Although it is clearly hard to put a dollar value on pain relief! Overall, they reported that the total savings of the 250,000 rotator cuff repairs performed annually saves the US $3.44 billion every year.