As we discussed in our previous post, “Just How Bad is Ugly Legs”, experts suggest that the annual U.S. taxpayer burden for vein-related ulcers is about $14.9 billion and climbing. Given how painful and expensive “ugly legs” can be, what if anything, can be done to prevent or stop it from getting worse?
Sadly, current industry practices guide healthcare practitioners to recommend outdated and cost-ineffective treatments that serve as literal band-aids to this problem. Since traditional treatment methods have become so lucrative to drug manufacturers, medical supply companies, and wound care treatment centers, there is little incentive to recommend alternative treatments even if they have been proven to be more effective.
Instead, much is written to maintain the status quo. In the April 2016 supplement to the Journal of Wound Care, the authors (who represent a major wound care society) reviewed compression techniques, dressing methods, and a variety of topical and ointment treatments. They concluded that “ugly legs” is a lifelong, chronic condition that is best treated with different kinds of compression. For more advanced cases, they recommend patients consider performing surgical treatments such as subfascial endoscopic perforator surgery (also known as SEPS) along with ligation and surgical stripping. They also acknowledged that since many of the patients that need this kind of advanced care might be too old to undergo such aggressive procedures, “new” ablation techniques should also be considered as possible options.
The irony of their recommendation is that not only are ablation techniques not new – they were first approved by the FDA over 12 years ago – but they are also now considered to be standard care because of how effective yet affordable they are.
Though there’s a lot of information to support ablation as the best-in-class treatment for “ugly legs,” insurance providers have not been quick to jump on the bandwagon. In fact, most insurance companies will require that conventional methods like compression therapy be used first before ablation should be recommended by doctors and before they’ll authorize coverage for this treatment. When this happens, it’s important for doctors to properly document the conventional methods that they tried so they can quickly move their patients onto ablations. By working in this way, doctors can focus on getting to a solution faster and not just giving patients a temporary fix.
While serious in its health effects and expensive to address, “ugly legs” is being mismanaged as private interests in our healthcare system outweigh what’s best for patients. Drug companies, bandage manufacturers, and large wound care management groups are incentivized to keep the status quo while evidence continues to pile up suggesting a better alternative is available to cure what has become a huge money-making “chronic” disease.
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