Eur Spine J 1996;5 Suppl 1:S21-5
Cost effectiveness of lumbar disc surgery and of a preventive treatment for
peridural fibrosis.
Schwicker D
HealthEcon, Basel, Switzerland.
STUDY DESIGN: This study used a retrospective modeling approach to predict the sequelae,
treatment patterns, and economic outcomes that patients treated or not treated with ADCON-L
Anti-Adhesion Barrier Gel can experience over a 1-year period following first-time surgery for
herniated lumbar disc. The study was designed for and carried out in the Netherlands.
OBJECTIVES: The study was carried out to investigate the economic impact of ADCON-L
application in lumbar disc surgery. SUMMARY OF BACKGROUND DATA: Patients with a
poor outcome following primary lumbar disc surgery represent a medical challenge to physicians
and an economic concern, as they often experience long-term sequelae. Patients who have failed
to benefit adequately from primary surgery tend to be very expensive patients, receiving a costly
array of conservative therapies, diagnostic measures and, sometimes, repeat surgery.
METHODS: A Markov model was constructed to integrate the retrospectively assessed
treatment patterns, economic outcomes, and costs of Dutch lumbar disc patients with the analysis
of the benefits of ADCON-L as shown in a clinical study population derived from the preliminary
results of a multicenter, randomized clinical trial of ADCON-L in Europe. RESULTS: Use of
ADCON-L can recoup 20% of its proposed initial cost of NLG 1000 in direct health care
savings during the first year after primary surgery. When indirect/societal as well as direct costs
are considered, for every Dutch guilder invested in ADCON-L treatment, savings of NLG 1.8
are achieved. CONCLUSIONS: In patients treated with ADCON-L during lumbar discectomy,
the quality of surgical outcome improves while cost per successful outcome is reduced. |
