Controlled CMS Data Demonstrates a Cost and Clinical Advantage for Hyperbaric Oxygen for Radiation Cystitis

Area of Science:

• Oncology
• Urology
• Hyperbaric Medicine

Background:

• Cancer survivorship is increasing due to advancements in radiation therapy.
• Delayed complications, such as radiation cystitis, remain a challenge despite improved techniques.
• Radiation cystitis can significantly impact patient quality of life and healthcare costs.

Purpose of the Study:

• To evaluate the value-based care of hyperbaric oxygen (HBO2) therapy for delayed radiation cystitis.
• To compare the cost and clinical effectiveness of HBO2 versus conventional therapies.
• To analyze Medicare data for patient outcomes and healthcare expenditures.

Main Methods:

• Retrospective review of 3,309 Medicare patients from October 2014 to December 2019.
• Utilized novel statistical modeling to compare a hyperbaric oxygen group with a control group receiving conventional care.
• Analyzed data for clinical outcomes (bleeding, transfusions, procedures, hospitalizations, mortality) and Medicare costs.

Main Results:

• HBO2 treatment resulted in a 36% reduction in urinary bleeding and a 78% decrease in blood transfusions.
• Endoscopic procedures and hospitalizations were reduced by 31% in the HBO2 group.
• A 53% reduction in mortality and average Medicare cost savings of $5,059 per patient were observed within the first year.
• Over 40 HBO2 treatments led to increased cost savings ($11,548 per patient) and better clinical outcomes, demonstrating a dose-response effect.

Conclusions:

• Adjunctive hyperbaric oxygen therapy is clinically beneficial and cost-effective for radiation cystitis.
• The study methodology offers unbiased comparative analysis and validates statistical modeling techniques.
• These findings support the integration of HBOT into routine care for managing delayed radiation cystitis.