Health Economics
Introduction: Literature has criticized hyperbaric oxygen therapy (HBOT) for being cost-prohibitive, costing thousands of dollars per treatment. However, the actual treatment costs of HBOT and the treatment protocols used for its indications have not been reported. We analyzed Hyperbaric Oxygen Therapy Registry (HBOTR) data to estimate the Medicare costs of HBOT based on standard treatment protocols and the annual mean number of treatments per patient reported by the registry.
Methods:
Methods: We performed a secondary analysis of deidentified data for all payers from 53 centers registered in the HBOTR from 2013 to 2022. We estimated the mean annual per-patient costs of HBOT using Medicare (outpatient facility + physician) reimbursement fees adjusted to 2022 inflation with the Medicare Economic Index. Costs were estimated for the annual average number of treatments patients received each year and for a standard 40-treatment series. The 2022 cost ranges of standard treatment protocols for HBOT indications treated in the outpatient setting were also estimated, based on the usual number of treatments per indication and the maximum number medically necessary.
Results:
Results: In 2022, a single HBOT session cost $595.86. From 2013 to 2022, the facility cost per patient per 40 HBOT treatments decreased by 10.7% from $21,568.58 to $19,488.00. The physician cost per patient per 40 treatments substantially decreased by 37.8% from $5,993.16 to $4,346.40. The total cost per patient per 40 treatments decreased by 15.6% from $27,561.74 to $23,834.40. For outpatient indications, estimated costs ranged from $2,383.4-$8,342.04 for crush injuries to a range of $17,875.80-$35,751.60 for diabetic foot ulcers and delayed radiation injuries.
Discussion:
Discussion: Findings from this real-world analysis of registry data collected over a 10-year period suggest that the cost of HBOT is not nearly as high as implied in previous literature. The per-patient cost to Medicare shows a decreasing trend, mainly due to decreased physician costs, with physicians making over a third less per patient in 2022 than in 2013.