Hyperbaric Oxygen Therapy - Hyperbaric Chamber Information ...

Table 80 Estimation of incremental cost per death avoided – 100 patients
100 patients Intervention Group
Comparison Group
(HBOT)
(no HBOT)
Incremental treatment
costs of HBOT
Incremental
$694,105 - $694,105
Survivals 76.5 33.3 43.1
Incremental cost per
death avoided
Sensitivity analysis
$16,105
Table 81 shows the results of the sensitivity analysis using the 95% CI of effectiveness,
and the sensitivity analysis varying the costs of a doctor in attendance during treatment,
varying the number of HBOT sessions per patient and the number of chambers in the
facility.
Table 81 Sensitivity analysis – survival in necrotising soft tissue infections
Sensitivity Analysis Incremental cost per death avoided at trial
completion
Difference of 9.7% (lower limit of 95% CI) $71,557
Difference of 76.6% (upper limit of 95% CI) $9,061
Cost of doctor/specialist covered by cost of patient assessment
prior to a course of HBOT treatment
$16,105 – primary case
$10,437
10 HBOT sessions per patient $5,368
15 HBOT sessions per patient $8,052
40 HBOT sessions per patient $21,473
Operating costs shared between 2 HBOT units $9,182
Operating costs shared between 4 HBOT units $5,721
Table 81 shows that if each patient has only 10 HBOT sessions, the incremental cost per
death avoided is $5,368. In the worst case scenario using the lower limit of the 95% CI of
the difference in effectiveness, the incremental cost per death avoided is $71,557.
Summary
The incremental HBOT treatment cost per death avoided is estimated to be $10,860, in
patients with necrotising soft tissue infections. The data suggests a 95% confidence that
the cost per life saved is less than $71,557. However it is unclear what the duration of the
effect is and whether the apparent survival gain from HBOT in this indication represents
a significant improvement in longevity. It should be noted that necrotising soft tissue
infections are relatively uncommon and therefore likely to represent a small part of the
throughput of an HBO unit. MSAC therefore needs to consider the potential cost
effectiveness of HBOT in this indication in the context of the wider use of HBOT.
Crush injuries
Bouachour et al 86 examined four major outcomes: wound healing without tissue necrosis
requiring surgical excision, new major surgical procedures after entry in the trial, time of
healing, and length of hospital stay (Table 46), in patients with Gustillo Type II or III
acute injury of the lower limb. Complete wound healing without tissue necrosis requiring
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