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Limb lengthening surgery is an effective therapeutic alternative for increasing the stature of persons with achondroplasia. The purpose of this study was to evaluate the cost-effectiveness of bone lengthening in patients with achondroplasia and to estimate the economic impact of the procedure on the Spanish health system by means of a Markov model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients with achondroplasia who undergo a limb lengthening procedure gain, on average, 5.954 quality-adjusted life years (QALYs) more than unoperated patients (27.197 vs. 21.243 QALYs). As the procedure entails a mean incremental cost of \u20ac49,480, the resulting incremental cost-effectiveness ratio (ICER) is \u20ac8,310\/QALY. The probabilistic sensitivity analysis (PSA) performed yielded a mean quality of life gain of 6.287 QALYs and a mean cost increase of \u20ac49,131, which translates into an ICER of \u20ac7,814\/QALY. The budget impact analysis was based on the hypothesis that all patients with achondroplasia born every year in the country used as a reference (Spain,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915) undergo the procedure. Under this assumption, a cumulative cost increase of \u20ac8,896,196 can be estimated over a 15-year period (\u20ac8,836,931 following the PSA).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Limb lengthening surgery in patients with achondroplasia can be considered a cost-effective intervention according to the most commonly accepted willingness-to-pay thresholds in Spain and other Western countries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13023-026-04397-0","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T09:19:01Z","timestamp":1779873541000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Limb lengthening in achondroplasia: a cost-effectiveness analysis using a Markov model"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7060-136X","authenticated-orcid":false,"given":"Pablo Oscar","family":"Roza Miguel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9286-2796","authenticated-orcid":false,"given":"Antonio","family":"Leiva Gea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1801-8061","authenticated-orcid":false,"given":"Mar\u00eda","family":"Rabanal Rubio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7865-327X","authenticated-orcid":false,"given":"Nuria","family":"Garc\u00eda-Rodr\u00edguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1091-815X","authenticated-orcid":false,"given":"Eduardo","family":"Gonz\u00e1lez Fidalgo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"4397_CR1","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1038\/s41574-021-00595-x","volume":"18","author":"R Savarirayan","year":"2022","unstructured":"Savarirayan R, Ireland P, Irving M, Thompson D, Alves I, Baratela WAR, et al. 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