A “tech gap” in which few amputees in the US are being approved to receive prosthetic limbs with more advanced, and therefore safer, technology than older and more dangerous technology is putting them at risk for preventable injury and death, according to a study conducted by RAND Corporation.
The study suggests that Medicare and private health insurers are denying access to new microprocessor-controlled knees (MPKs) that are only slightly more expensive over a lifetime and considerably safer than alternative “1970s-style” artificial lower limbs.
According to the study, per a media release from the American Orthotic & Prosthetic Association, Medicare total payments for prosthetics declined 15% between 2010 and 2014 despite advances in technologies.
In addition, the release explains, the study shows that 26% of patients who received more advanced prosthetic limbs with MPK will fall per year as opposed to 82% of patients with the older non-MPK limbs. There are 14 fall-related deaths per 10,000 patient years for non-MPK amputees, and three fall-related deaths per 10,000 patient years for the MPK amputees, which means up to 11 lives per 10,000 patient years could be saved through wider MPK usage.
The data show only 38 falls per 10,000 patient years, resulting in injuries suffered by users of the higher-tech MPK versus 182 falls per 10,000 patient years for non-MPK amputees.
Dr Soeren Mattke, managing partner, Health Care Practice, RAND Corporation, Boston, shares in the release that, “Due to recent advances in technologies, prosthetic knees and feet allow for more dynamic movements and improve user quality of life, but payers have recently started questioning their value for money … the microprocessor-controlled knee is associated with sizable improvement in physical function and reductions in incidences of falls and osteoarthritis …The results suggest that the incremental cost of MPK is in line with commonly accepted criteria for good value for money and with the incremental cost of other medical devices that are currently covered by US payers.”
Summarizing the findings of a recent Mayo Clinic study, Kenton Kaufman, PhD, Department of Biomedical Engineering, Mayo Clinic, Rochester, MN, adds, “Even if an amputee with the older technology avoids death due to a fall, he or she may suffer very serious consequences from a fall-related injury. The average additional cost in the six months following a fall can be substantial.”
Michael Oros, CPO and president, American Orthotic & Prosthetic Association, and CEO, Scheck & Siress, Chicago, states, “This is not a case of amputees wanting to have access to new technology just because it is new. To the contrary, new tech versus old tech can be a life-and-death issue for an amputee. The RAND Corporation study shows that there is a much higher risk of injury or death when Medicare and private payers refuse to permit access to the only slightly more expensive new generation of artificial knee and lower limb. And there is a huge quality of life issue here. Amputees who are stuck with the 1970s-style tech tend to be less mobile in addition to being more vulnerable to risk of injury or death.”
[Source(s): American Orthotic & Prosthetic Association, PR Newswire]
