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

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