Hyperbaric Oxygen Therapy - Hyperbaric Chamber Information ...
Hyperbaric Oxygen Therapy - Hyperbaric Chamber Information ...
Hyperbaric Oxygen Therapy - Hyperbaric Chamber Information ...
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Reactive effects<br />
A reactive effect can occur when patients are aware that they are participating in an<br />
experimental trial and they react to the context rather than the treatment. Since all<br />
HBOT studies were conducted under standard clinical conditions, the potential for this<br />
type of bias would appear to be small.<br />
What are the economic considerations?<br />
Introduction<br />
The purpose of this economic appraisal is to give some indication of the likely value for<br />
money of monoplace hyperbaric oxygen therapy (HBOT) in Australia. Multiplace<br />
chambers were not included in the appraisal as the majority of multiplace treatments are<br />
provided through the public hospital system. The cost per patient treated in the current<br />
public multiplace units are likely to be higher than in a monoplace unit given the wider<br />
role of multiplace units including the provision of 24 hour emergency care. We assessed<br />
value for money by calculating the likely extra cost per additional unit of improved health<br />
outcome for a range of indications for HBOT. The ratio of additional cost to additional<br />
benefit is termed the ‘incremental cost effectiveness ratio’.<br />
The overall cost effectiveness of hyperbaric monoplace hyperbaric oxygen therapy<br />
(HBOT) will depend on (a) the cost per course of treatment, (b) the effectiveness of<br />
treatment in each indication treated, and (c) the mix of indications treated. Given the<br />
high fixed cost of treatment the average cost per course of treatment will be dependent<br />
on throughput and the degree of capacity utilisation. The effectiveness of treatment is<br />
likely to vary across indications. The overall extra cost per unit of additional outcome or<br />
incremental cost effectiveness ratio will be a weighted average of the cost-effectiveness in<br />
the indications for which HBOT is used, where the weights are the share of capacity<br />
used. Given that the indications do not have homogeneous outcomes, it was not possible<br />
to calculate a single cost effectiveness ratio.<br />
No published cost-effectiveness studies or cost studies of HBOT in Australia were<br />
found. A series of indicative cost-effectiveness ratios were calculated for a number of<br />
indications for HBOT which have shown some clinical evidence of effectiveness. The<br />
indicative cost-effectiveness analysis in this appraisal uses costs of HBOT treatment<br />
based on expert opinion combined with the results from the effectiveness assessment in<br />
this report. It does not represent a full economic analysis of the value of HBOT. It is<br />
limited by data on effectiveness from the clinical trials reviewed. Resource use associated<br />
with monoplace hyperbaric oxygen therapy has been estimated using a combination of<br />
data from clinical trials and expert opinion. Some very limited modelling was done to<br />
generalise resource use associated with disease treatment pathways. The estimated direct<br />
cost of HBOT in a monoplace unit has not been based on a prospective study of<br />
treatment in practice. Nor have the implications for disease management been fully<br />
assessed. The appraisal represents only an indication of the potential cost effectiveness of<br />
monoplace HBOT, rather than a complete and detailed estimate of the cost effectiveness<br />
analysis of the technology.<br />
Cost of HBOT<br />
The cost of HBOT is composed of capital and operating costs. Operating costs include<br />
staff, maintenance and overhead costs. The cost per session and per treatment depends<br />
on the duration and number of sessions per annum. Two studies on the use of HBOT in<br />
<strong>Hyperbaric</strong> oxygen therapy 81