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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.