Illustration of Cost Saving Implications of Lower Extremity Nerve Decompression to Prevent Recurrence of XXXX .

@entity6 @entity5663 @entity3949 @entity1746 @entity4760
UNASSIGNED: The US @entity4760 ( @entity4760 ) incidence is 3-4% of 22.3 million diagnosed @entity6 cases plus 6.3 million undiagnosed, 858 000 cases total. Risk of recurrence after healing is 30% annually. @entity1746 ( @entity5663 ) surgery reduces neuropathic @entity4760 (nDFU) recurrence risk by >80%. Cost effectiveness of hypothetical @entity5663 implementation to minimize nDFU recurrence is compared to the current  6.171 billion annual nDFU expense. A literature review identified best estimates of annual incidence, recurrence risk, medical management expense, and noneconomic costs for @entity4760 . Illustrative cost/benefit calculations were performed assuming widespread application of bilateral @entity5663 after wound healing to the nDFU problem, using Center for Medicare Services mean expense data of  1143/case for unilateral lower extremity @entity5663 . Calculations use conservative, evidence-based cost figures, which are contemporary (2012) or adjusted for inflation. Widespread adoption of @entity5663 after nDFU healing could reduce annual @entity4760 occurrences by at least 21% in the third year and 24% by year 5, representing calculated cost savings of  1.296 billion (year 3) to  1.481 billion (year 5). This scenario proffers significant expense reduction and societal benefit, and represents a minimum 1.9* return on the investment cost for surgical treatment. Further large cost savings would require reductions in initial @entity4760 incidence, which @entity5663 might achieve by selective application to advanced @entity3949 ( @entity3949 ). By minimizing the contribution of recurrences to yearly nDFU incidence, @entity5663 has potential to reduce by nearly  1 billion the annual cost of @entity4760 treatment in the United States.
