Can Smart Orthotics Have An Impact In Preventing Ulceration?
- Volume 23 - Issue 6 - June 2010
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“While this is, in principle, an attractive concept, I think the reality is that the cost of a system like this would make it unappealing to both patients and healthcare providers,” notes Dr. Davis.
If smart orthotics become available, do you think the insurance companies will cover the expenses related to the use of these devices?
Dr. Davis says the key to insurance coverage is validating the cost-effectiveness of new solutions such as smart orthoses. He says double-blind studies are necessary to compare orthotics with smart orthotics, and longitudinal studies are necessary for matched patient cohorts with the endpoint of a documented reduction in ulcer incidence. Dr. Davis notes such studies are relatively expensive as they require well over 100 patients per group, with each group usually needing to be tracked for 12 to 24 months.
“With this said, there is probably no easier approach to reduce ulcers than one that focuses on the use of appropriate footwear,” offers Dr. Davis.
If the profession confirms that smart orthotics are more effective than present orthotic devices, Dr. Yavuz advocates that insurance companies should cover them. Given the high cost of the diabetic foot and amputations, he says if smart orthotics have reasonable purchase and maintenance costs, they can present a “win-win situation for all parties,” including patients, healthcare providers and insurance companies.
Dr. Erdemir is uncertain that insurance companies will cover smart orthotic devices. However, he feels establishing the efficacy of orthotics to prevent foot ulceration and an analysis of cost savings associated with prevention via footwear prescription are necessary steps that can encourage policy makers and insurance companies to adopt such practices.
Dr. Davis is the Vice President and Director of the Medical Device Development Center at the Austen BioInnovation Institute in Akron, Ohio.
Dr. Erdemir is the Director of the Computational Biomodeling Core and a Staff Scientist in the Department of Biomedical Engineering/ND-20 at Lerner Research Institute in Cleveland, Ohio.
Dr. Yavuz is an Assistant Professor in the Department of Basic Sciences at the Ohio College of Podiatric Medicine.
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