Cost effectiveness evaluation of ADCON-L adhesion control gel in lumbar surgery.
Patients, physicians and third-party payers are becoming increasingly concerned with the economic burden resulting from advances in health care. Many economic health studies have focused on patients with sciatica and low back pain. An Economic Survey was conducted on lumbar discectomy patients who had been enrolled at least 12 months prior in a prospective randomized controlled clinical study of the adhesion control device ADCON-L. The survey measured patient satisfaction, return to work, additional medical treatment and medications after surgery. In addition, the duration of any re-operations from patients in the clinical study was analyzed. The results of the Economic Survey and re-operation time analysis show significant advantages for lumbar discectomy patients who received ADCON-L compared to control patients who did not. Patients who received ADCON-L not only had less scarring and less back pain than control patients but also were more satisfied with their surgeries and were able to return to work more often, as originally planned (p = 0.02). In addition, ADCON-L patients returned to their original jobs an average of 3.6 days sooner, changed jobs 50% less often, did not seek additional medical treatment as often, and took 20% less pain medication than did control patients (p = 0.01). In addition, patients receiving ADCON-L who required subsequent re-operation at the same lumbar space (e.g., reherniation) had a significantly shorter duration of secondary surgery (56.6 min vs. 130 min, p = 0.001) compared to patients who did not receive ADCON-L at the first surgery. Overall, ADCON-L patients demonstrated significant clinical and economic advantages over control patients. If all lumbar surgical patients in the US were to receive ADCON-L, annual savings to the health care system would exceed one half billion dollars.
McKinley
D S
DS
Gliatech Inc., Cleveland, OH 44122, USA.
Shaffer
L M
LM
D002448:Cell Adhesion / Q000187:drug effects; D003362:Cost-Benefit Analysis; D005069:Evaluation Studies as Topic; D005782:Gels / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D009930:Organic Chemicals; D012086:Reoperation; D016896:Treatment Outcome; D014481:United States
C104199:ADCON-L; D005782:Gels; D009930:Organic Chemicals