PGD3 Cost-Utility Relation of the Treatment of Diabetic Foot Lesion with Hyperbaric Oxygene Therapy Versus Standard Therapy

• Published in: Value in health Vol. 1; no. 1; pp. 57 - 58
• Main Authors: Kilburg, A, Rychlik, R, Rappenhöner, B
• Format: Journal Article
• Language: English
• Published: Oxford, UK Elsevier Inc 01.05.1998; Blackwell Science Inc
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1046/j.1524-4733.1998.1100573.x

Diabetes mellitus is a major and growing European health problem at all ages and all countries. Diabetic angiopathy leads to chronic foot lesion and has a high risk of amputation. In clinical studies the effectiveness of Hyperbaric oxygene therapy of diabetic foot lesion was proved. Hyperbaric oxygene therapy adjunctive to therapy of diabetic food lesion can reduce anaerobic infections, improve blood supply and decrease ischemic damage to nerves. OBJECTIVE: This analysis centred around which of the alternative therapies‐standard therapy plus Hyperbaric oxygene therapy and standard therapy alone‐incurs the best cost‐effectiveness ratio. The comparison of costs and benefits was made on the basis of a cost‐effectiveness analysis. METHODS: A decision tree with four endpoints was constructed: (1) successful therapy without amputations, (2) small amputations, (3) major amputations with post hospital treatment, and (4) major amputation with domestic nursing. Data regarding the number and severity of amputations underlying were taken from a clinical study. Health care costs included in the model were all medical costs (hospitalisation, surgical intervention, drug costs, etc.) and indirect costs (absence from workplace, retirement). The effectiveness was defined as avoided major amputation. The following effectiveness rates were revealed in the clinical study: population with adjunctive Hyperbaric oxygene therapy, 0.9143; population only with standard therapy, 0.6666. To improve the robustness of the model, a sensitivity analysis was performed to determine the influence of the efficacy on the incremental cost‐effectiveness ratio and the effects of the costs of post hospital treatment based on the incremental costeffectiveness ratio. RESULTS: Standard therapy plus hyperbaric oxygene therapy resulted in total costs of DM 45,141.00 per successfully treated patient; standard therapy incurred total costs of DM 52,392.00 per successfully treated patient. CONCLUSION: The decision tree analysis reveals that the treatment of diabetic foot lesion with adjunctive Hyperbaric oxygene therapy has the best incremental cost‐effectiveness ratio.