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KCE Reports 74 Hyperbaric Oxygenation Therapy 67<br />

5.8.3 Transportation cost<br />

As a general rule, outpatient transportation costs are to be paid by <strong>the</strong> patient. As an<br />

exception, for radionecrosis patients having HBOT as part of <strong>the</strong>ir follow-up after<br />

chemo- and radio<strong>the</strong>rapy, transportation costs may be reimbursed under public<br />

regulations, following a Ministerial Decree of July 6, 1989, and modified by a ministerial<br />

decree of May 25, 2007. d<br />

Transportation costs (two-way) are <strong>the</strong>n reimbursed according to public transports<br />

travel expenses or at a rate of €0.25 per kilometre.<br />

5.9 COST ANALYSIS FROM A HOSPITAL’S POINT OF VIEW<br />

The aim of this analysis is to evaluate <strong>the</strong> cost of a hyperbaric oxygen session. The costs<br />

included are both capital costs (<strong>the</strong> hyperbaric chamber investment) and operational<br />

costs (personnel costs, maintenance costs, oxygen and compressed air, patient<br />

consumables, and o<strong>the</strong>r overhead costs). Costs not included in this analysis are <strong>the</strong> pretreatment<br />

consultation costs of <strong>the</strong> physician, hospitalization costs, and transportation<br />

costs. O<strong>the</strong>r costs for e.g. intensive care patients are also disregarded. We would like<br />

to stress that this cost analysis is a <strong>the</strong>oretical calculation of costs. Fur<strong>the</strong>r research to<br />

ga<strong>the</strong>r more detailed real-world cost data is desirable.<br />

5.9.1 Investment costs and expected lifetime of equipment<br />

The investment price for multiplace chambers was obtained from Hytech, a supplier<br />

from <strong>the</strong> Ne<strong>the</strong>rlands, which only sells multiplace chambers but no monoplace<br />

chambers. We also received price information from ETC, an international supplier<br />

(headquartered in <strong>the</strong> US), however, given <strong>the</strong> higher shipping costs, we preferred to<br />

use <strong>the</strong> price information from <strong>the</strong> Dutch company. For monoplace chambers, we used<br />

price information from ETC and an indicative market price from Hytech. Table 15<br />

shows <strong>the</strong> average cost and ranges which were used in our cost analysis. To check<br />

<strong>the</strong>se numbers, <strong>the</strong> obtained multiplace chamber price data was compared with figures<br />

we received from two Belgian hospitals. Their investment cost, adjusted for inflation,<br />

showed comparable figures. For monoplace chambers, Treweek et al. 133 (2006)<br />

calculated a price of £102 000 (or about €144 000) for <strong>the</strong> chamber and <strong>the</strong> oxygen<br />

recirculation system. This cost falls within our price range.<br />

Table 15. Investment cost<br />

Investment cost (VAT incl.)*<br />

Range (€) Average (€) Lifetime<br />

Multiplace chamber 12 persons 750 000 – 850 000 800 000 25 ys +<br />

Multiplace chamber 6 persons 660 000 – 760 000 710 000 25 ys +<br />

Monoplace chamber 115 000 – 165 000 140 000 10 ys +<br />

VAT: value-added tax<br />

* Including shipping and installation costs<br />

According to <strong>the</strong> vendors of hyperbaric chambers, <strong>the</strong> expected lifetime of a multiplace<br />

chamber is 25 to 30 years or even more. Today, <strong>the</strong>re are examples of multiplace<br />

chambers that were built more than 30 years ago and that are still in use. According to<br />

<strong>the</strong> manufacturers, multiplace chambers would have a more extended lifetime than<br />

monoplace chambers.<br />

d MB tot wijziging van het MB van 6 juli 1989 tot vaststelling van de tegemoetkoming van de verplichte<br />

ziekte- en invaliditeitsverzekering en van de toekenningsvoorwaarden voor die tegemoetkoming in de<br />

reiskosten van ambulant behandelde patiënten aangetast door ziekten die hetzij een chemo<strong>the</strong>rapeutische<br />

behandeling bij middel van geneesmiddelen behorend tot de categorie A, hetzij een behandeling met<br />

stralingen vergen.<br />

AM du 6 juillet 1989 fixant l'intervention de l'assurance obligatoire contre la maladie et l'invalidité et les<br />

conditions d'octroi de cette intervention dans les frais de voyage des patients traités ambulatoirement<br />

atteints de pathologies nécessitant soit un traitement chimiothérapique au moyen d'une médication de la<br />

catégorie A, soit un traitement par radiations.

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