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The Financial Burden Of Lymphedema Treatment On The Patient
Shayan M. Sarrami, MD
1,
Alexis M. Henderson, MPH2, Benjamin B. Scott, MD
1, Meeti Mehta, BS
2, Erica Onuoha, MPH
2, Carolyn De La Cruz, MD
1.
1University of Pittsburgh Medical Center, Pittsburgh, PA, USA, 2University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
PURPOSE: Long-term lymphedema management can impose a significant financial burden on patients, but previous reports could not fully assess out-of-pocket costs. We reviewed four years of a single insurer’s financial data at one lymphatics center to investigate the economic impact on patients.
METHODS: A retrospective review of patients with direct provider insurance undergoing lymphedema care from 2019-2023 included data on insurance charges and patient payments. Patients were grouped by treatment strategy: conservative (compression garments, pneumatic compressors), surgical (liposuction debulking, lymphovenous anastomosis), or preventative (immediate lymphatic reconstruction). Cost comparisons used Student’s t-test or ANOVA with post hoc analysis.
RESULTS: Out of 921 patients needing lymphedema care under provider insurance (totaling 2,320 treatments), 99% (n=909) underwent conservative care; 266 used compression and 643 used pump therapy. Average cost for conservative management was $14,648 per patient, with an average out-of-pocket expense of $9,765. Payments for pump therapy averaged $8,470±$21,223 compared to $1,360±$4,159 for compression, a significant difference (p<0.001). Custom heavy garments were also significantly costlier (p<0.001). Surgical care (2%, n=18) mainly involved liposuction debulking (n=15); LVAs cost $3,317±$2,426, less than debulking at $6,770±$10,188, though not significantly different. Preventative ILR (n=3) had a median cost of $1,985. For nine patients who received both surgical and conservative care, the median payment was $8,990, reflecting the 4-year cost of lymphedema care.
CONCLUSION: Lymphedema management often incurs high costs, influenced by patient and treatment factors. While conservative care is common, surgical and preventative options may reduce long-term expenses. As treatments evolve, considering patient financial impact is essential.
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