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Diabetic Foot Ulcers: cost realities

Hey, everyone! I recently discovered an excellent site called diabetesfootulcer.com. It is absolutely PACKED with great information about diabetic foot ulcers. If the producer of this website was aiming for a thorough and well-done look at DFU’s, I’d say they achieved it.

Since I’m always looking for cost references, I was so excited by the information I found here. For example, did you know that the annual cost of healing just ONE ulcer with conventional care is $56,516? CRAZY.

Also, I learned that 2/3 or diabetes-related amputations are actually paid for by Medicare. And the cost of a major amputation? $45,000 according to the research on this website.

ACI Medical rents the ArtAssist® device at $1200/3 months to Veteran’s Administrations around the country, at no cost to our veterans. The alternative is 37.5 times more expensive. Our government has enough money troubles, wouldn’t you say?

via Diabetic Foot Ulcers: cost realities.

How was this possible? Learn more by clicking the healed foot:

More research into the cost of lower-limb amputation

Recently, while summarizing key studies for a history and literature review that I’m working on, I was reminded that this particular study (the abstract is below) also included comparative costs.

In this case, you will see that although SCBD (in other words, ArtAssist®) therapy doesn’t exactly come cheap, it’s still less than half the average cost of a primary amputation.

Want to hear even better news? This study yielded an 88% limb salvage rate, even after 18 months. Fancy that.

Edit: A 3-month rental of the ArtAssist® device in the United States is more than 36 times less expensive than the cost of primary amputation per patient, according to the following study. And even if you take the SCBD patient cost (below), it still sounds like a better deal to me.

Nonoperative Active Management of Critical Limb Ischemia: Initial Experience Using a Sequential Compression Biomechanical Device for Limb Salvage

Sherif Sultan; Olubunmi Esan; Anne Fahy

Department of Vascular and Endovascular Surgery, Western Vascular Institute, University College Hospital Galway, Galway, Ireland

Vascular 2008;163:130-139

Critical limb ischemia CLI patients are at high risk of primary amputation. Using a sequential compression biomechanical device SCBD represents a nonoperative option in threatened limbs. We aimed to determine the outcome of using SCBD in amputation-bound nonreconstructable CLI patients regarding limb salvage and 90-day mortality.

Thirty-five patients with 39 critically ischemic limbs rest pain = 12, tissue loss = 27 presented over 24 months. Thirty patients had nonreconstructable arterial outflow vessels, and five were inoperable owing to severe comorbidity scores. All were Rutherford classification 4 or 5 with multilevel disease. All underwent a 12-week treatment protocol and received the best medical treatment.

The mean follow-up was 10 months SD ± 6 months. There were four amputations, with an 18-month cumulative limb salvage rate of 88% standard error [SE] ± 7.62%. Ninety-day mortality was zero. Mean toe pressures increased from 38.2 to 67 mmHg SD ± 33.7, 95% confidence interval [CI] 55 – 79. Popliteal artery flow velocity increased from 45 to 47.9 cm/s 95% CI 35.9 – 59.7. Cumulative survival at 12 months was 81.2% SE ± 11.1 for SCBD, compared with 69.2% in the control group SE ± 12.8% p = .4, hazards ratio = 0.58, 95% CI 0.15 – 2.32. The mean total cost of primary amputation per patient is €29,815 ($44,000) in comparison with €13,9000 ($20,515) for SCBD patients.

SCBD enhances limb salvage and reduces length of hospital stay, nonoperatively, in patients with nonreconstructable vessels.

via ACI Medical – ArtAssist® Device.