will mediare pay for leg compression machine

#Will mediare pay for leg compression machine trial

7, 8 Alternative treatments including surgical interventions have been proposed. 6 However, adherence to compression therapy is poor due to uncomfortableness. The traditional standard of care for VLU is compression therapy, which has been demonstrated as clinically beneficial. 3, 4 The estimated annual cost of VLU treatment exceeds $3.5 billion. 1, 2 The United States, prevalence of VLU ranges from 0.15% to 0.30%, equating to approximately 600 000 cases per year, and is higher among women and older patients. VLUs lead to significant disability, reduced quality of life, and tremendous economic burden. Venous leg ulcers (VLU) are the most common cause of lower extremity ulceration and are characterized by slow healing trajectory and frequent recurrence. Payers should prioritize coverage for early ablation to prevent VLU complications rather than treat a costly outcome that also reduces patient well-being. The probabilistic sensitivity analysis showed that early ablation was cost-effective in 59.2% of simulations at the $100 000/QALY threshold.Ĭonclusions and Relevance In this economic evaluation of compression therapy with early endovenous ablation, early intervention was dominant, as it was cost saving and generated greater QALYs over 3 years from the US Medicare perspective. Probability of healing, followed by the probability of recurrence, was the parameter with greatest impact on model uncertainty. At a $100 000/QALY cost-effectiveness threshold, the incremental net monetary benefit was $5226 per patient in favor of early ablation. Early ablation dominated, with a lower per-patient cost of $12 527 and an increase of 2.011 QALYs, whereas compression therapy with deferred ablation yielded a per-patient cost of $15 208 and 1.985 QALYs gained. Results This model used a simulated cohort of patients with VLU aged 65 years and older enrolled in Medicare. Univariate and probabilistic sensitivity analyses were performed to test uncertainty of model results. Main Outcomes and Measures Direct medical costs, quality-adjusted life years (QALYs), and the incremental monetary benefits at a willingness-to-pay threshold of $100 000/QALY. Data were analyzed from September 2021 to June 2022.

#Will mediare pay for leg compression machine trial

The simulated cohort included patients with VLU aged 65 years and older who had clinical characteristics similar to those in the randomized Early Venous Reflux Ablation trial in the United Kingdom. Objectives To evaluate the cost-effectiveness of early endovenous ablation of superficial venous reflux in patients with VLU from the US Medicare perspective.ĭesign, Setting, and Participants This economic evaluation used a Markov model to simulate the disease progression of VLU for patients receiving compression therapy with early vs deferred ablation over 3 years. Clinical trial data show that early intervention with endovenous ablation substantially improves the healing rate and reduces recurrence among patients with VLUs, but there is a need to assess the cost-effectiveness of early endovenous ablation in the US context. Importance Venous leg ulcers (VLU) are the most common cause of lower extremity ulceration that commonly occur among older individuals and are characterized by a slow healing trajectory and frequent recurrence in the United States, VLUs affect more than 600 000 people per year with an estimated cost of $3.5 billion. Shared Decision Making and Communication.

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