Hailey D, Jacobs P, Chuck A; Health Technology Assessment International. Meeting (3rd : 2006 : Adelaide, S. Aust.).
Handb Health Technol Assess. 2006; 3: 4.
Department of Community Health Sciences, University of Calgary, 22 Sinclair Street, Kambah, Canberra
Background: Hyperbaric oxygen therapy (HBOT) has been suggested as an adjunct to standard methods of care for diabetic foot ulcers (DFU). Its use may decrease the risk of infection and lower extremity amputations (LEAs), though available evidence is only of fair quality. As part of a Canadian assessment, we estimated the cost-effectiveness and budget impact of HBOT in this application. Methods: We developed a decision model comparing adjunctive HBOT with standard care alone. The population was a 65 year-old cohort with DFU, the time horizon 12 years and the perspective that of a Ministry of Health. The health states were a healed wound with or without a minor LEA, an unhealed wound with no related surgery and a major LEA. Cost and capacity needs for treating DFU patients in Canada were estimated using prevalence data from the literature and provincial cost and utilization data. Results: The 12-year cost for patients receiving HBOT was C$40,695 compared to C$49,786 for standard care alone. Outcomes were 3.64 QALYs for those receiving HBOT and 3.01 QALYs for controls. Estimated cost to treat all prevalent DFU cases in Canada was C$7.3 million/year over four years. If seven person multiplace HBOT chambers were used, the equivalent of 12.4 machines would be required nationally. Conclusions: Adjunctive HBOT for DFU is cost-effective compared with standard care. Additional HBOT capacity would be needed if it were to be adopted as the standard of care throughout Canada. A concern is that evidence of clinical benefit remains limited, suggesting the need for good quality comparative studies under Canadian conditions.
Publication Types:
Keywords:
- Amputation
- Canada
- Cost-Benefit Analysis
- Diabetic Foot
- Humans
- Hyperbaric Oxygenation
- Prevalence
- Quality-Adjusted Life Years
- economics
- surgery
- hsrmtgs
UI: 103724770
From Meeting Abstracts