Impact of radiofrequency ablation for patients with varicose veins on the budget of the German statutory health insurance system

Abstract

ObjectivesIn contrast to other countries, surgery still represents the common invasive treatment for varicose veins in Germany. However, radiofrequency ablation, e.g. ClosureFast, becomes more and more popular in other countries due to potential better results and reduced side effects. This treatment option may cause less follow-up costs and is a more convenient procedure for patients, which could justify an introduction in the statutory benefits catalogue. Therefore, we aim at calculating the budget impact of a general reimbursement of ClosureFast in Germany.MethodsTo assess the budget impact of including ClosureFast in the German statutory benefits catalogue, we developed a multi-cohort Markov model and compared the costs of a “World with ClosureFast” with a “World without ClosureFast” over a time horizon of five years. To address the uncertainty of input parameters, we conducted three different types of sensitivity analysis (one-way, scenario, probabilistic).ResultsIn the Base Case scenario, the introduction of the ClosureFast system for the treatment of varicose veins saves costs of about 19.1 Mio. € over a time horizon of five years in Germany. However, the results scatter in the sensitivity analyses due to limited evidence of some key input parameters.ConclusionsResults of the budget impact analysis indicate that a general reimbursement of ClosureFast has the potential to be cost-saving in the German Statutory Health Insurance.

Vascular training does matter in the outcomes of saphenous high ligation and stripping

“…19,20 With that, one tends to forget that classic surgery remains the most frequent treatment modality in several countries, such as Spain 18 and Germany. 21 Furthermore, the better outcomes and cost-effectiveness of the endovenous techniques remain debatable. 20,22 In that regard, assessing high ligation and stripping outcomes in the real world remains an important subject and should not be overlooked.…”

Cost-effectiveness analysis of five procedures for great saphenous vein reflux in a Norwegian healthcare setting or societal setting

“…In a work by Kuhlmann and co-workers, varicose vein treatment by HL/S and RFA was modelled in the Statutory German Health Insurance setting. 5 They found that the robustness of the economic analysis deteriorated as the time horizon increased due to the lack of good input data. In light of this potential trade-off between the accuracy of the model and the completeness of the perspective, we believe that this work gives an adequate presentation of the alternative procedures.…”

“…A recent example is a German study investigating the impact of reimbursement of a radiofrequency ablation (RFA) procedure for varicose veins. 5 The results of the analysis indicated that a general reimbursement of the procedure through the German Statutory Health Insurance could lead to cost saving for the healthcare sector.…”

Clinical utility of the Covidien Closure Fast™ Endovenous Radiofrequency Ablation Catheter

“…In Germany, the impact of the introduction of Closure Fast™ to the statutory health insurance catalog was assessed. 30 Using a multi-cohort Markov model, which looks at the number of procedures a patient needs to remain free of the symptoms of varicose veins over 5 years, the introduction of Closure Fast™ would save €19.1 million when compared with open surgery. If Closure Fast™ was not used, of the estimated 1.6 million procedures done over 5 years, 38% would have required an inpatient stay.…”