Cost effectiveness of lumbar disc surgery and of a preventive treatment for peridural fibrosis.
METHODS
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.


OBJECTIVE
The study was carried out to investigate the economic impact of ADCON-L application in lumbar disc surgery.


BACKGROUND
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.
Schwicker
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HealthEcon, Basel, Switzerland.
D003362:Cost-Benefit Analysis; D017586:Diskectomy / Q000191:economics*; D004388:Dura Mater / Q000187:drug effects / Q000473:pathology*; D005355:Fibrosis; D005782:Gels / Q000627:therapeutic use*; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008962:Models, Theoretical; D009930:Organic Chemicals; D011183:Postoperative Complications / Q000517:prevention & control*; D011315:Preventive Medicine / Q000191:economics* / Q000379:methods*; D012680:Sensitivity and Specificity; D013118:Spinal Cord Diseases / Q000517:prevention & control
C104199:ADCON-L; D005782:Gels; D009930:Organic Chemicals