Chuck AW, Hailey D, Jacobs P, Perry DC, et al.
International journal of technology assessment in health care. Date of publication 2008 Apr 1;volume 24(2):178-83.
1. Int J Technol Assess Health Care. 2008 Spring;24(2):178-83. doi:
10.1017/S0266462308080252.
Cost-effectiveness and budget impact of adjunctive hyperbaric oxygen therapy for
diabetic foot ulcers.
Chuck AW(1), Hailey D, Jacobs P, Perry DC.
Author information:
(1)University of Alberta, Alberta, Canada. achuck@ihe.ca
BACKGROUND: Hyperbaric oxygen therapy (HBOT) has been proposed 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). 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
was 12 years taken from a Ministry of Health perspective. The health states were
a healed wound with or without a minor LEA, an unhealed wound with no related
surgery, and a major LEA. Efficacy data were based on outcomes reported in
studies included in a literature review. Cost and capacity needs for treating DFU
patients in Canada were estimated using prevalence data from the literature, and
cost and utilization data from government records.
RESULTS: The 12-year cost for patients receiving HBOT was CND$40,695 compared
with CND$49,786 for standard care alone. Outcomes were 3.64 quality-adjusted
life-years (QALYs) for those receiving HBOT and 3.01 QALYs for controls.
Estimated cost to treat all prevalent DFU cases in Canada was CND$14.4-19.7
million/year over 4 years. If seven-person HBOT chambers were used, a further
nineteen to thirty-five 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.
DOI: 10.1017/S0266462308080252
PMID: 18400121 [Indexed for MEDLINE]
Appears in following Topics:
