The terms “colostomy”, “ileostomy”, and “urostomy” are not well known terms to the general public outside of the patients who need these surgical procedures in order to survive. Ostomy care following surgery is not sexy and not easily discussed publicly, given that such surgeries involve changing the manner in which people eliminate fecal or urinary waste from their bodies.
Thousands of Europeans have had ostomy surgery as a result of colon or rectal cancer and other congenital anomalies. Individualised ostomy products in combination with access to trained ostomy nurses for support increase quality of life for these patients. Will reimbursement policies turn out to make sense for patients?
A must for thousands of Europeans
Ostomy care, however, is essential for thousands of patients across Europe who have undergone ostomy surgery as a result of colon or rectal cancer, congenital anomalies, Crohn’s disease, Ulcerative Colitis, or trauma to the gastrointestinal tract (such as a gunshot or stab wound).[i] In order to allow the digestive system to continue functioning, the diseased or damaged portion of the intestine or urinary system is removed and the remaining bowel or urinary system is diverted to an opening is created in the abdomen.
Collection of waste is accomplished through the use of an ostomy management system consisting of a skin barrier and pouch attached over the opening on the abdomen. In most cases, patients require an ostomy collection system for the rest of their lives following surgery.
A bag is not just a bag
In order to ensure patients do not experience serious medical complications as a result of leakage due to a poor fitting ostomy system, skin barriers and pouches are manufactured in hundreds of different constructions and designs. Specially-trained healthcare professionals evaluate each patient’s surgery-type, skin type, body type, and personal needs and prescribe the most appropriate ostomy management system for each patient – the same as any other prosthetic device.
Despite the unique, prosthetic nature of ostomy supplies, most European community reimbursement systems consider ostomy supplies as generic—meaning that reimbursement systems do not recognise the need for individualised products, nor do they provide adequate incentives for companies to innovate in ostomy care. To European payers, a bag is a bag. To ostomy patients, access to the unique ostomy system that has been medically prescribed for them can mean the difference between living a normal life, and continuous hospital visits with unnecessary, painful and costly skin complications. In France alone, for example, skin complications in ostomy care account for an additional €25.4 million annually. [ii]
Reimbursement that makes sense for patients
If we are going to reduce the costly post-surgical complication rates of ostomy patients (which have changed little over the past 50 years)[iii] and help patients return to more normal, productive and healthy lives, policymakers must encourage rather than discourage patient access to the prescribed products they depend on each day, and encourage innovation of new ostomy management devices and techniques through improved reimbursement and funding mechanisms in the community where most ostomy management takes place.
Health systems can still save money
Reimbursement policies that recognise ostomy products as prosthetic supplies, together with access to trained ostomy nurses to support patients, would lead to significant cost savings. It would also improve the quality of life for the thousands of ostomy patients who are now suffering in silence.
They most certainly care about ostomy bags.
To learn more about improving the accessibility of effective healthcare for ostomy patients in the community, click here.
– Klaus Grunau, Senior Director Healthcare Policy & Development, Hollister Incorporated
[i] Eucomed. Background Paper on Access to Ostomy Supplies and Innovation.
[ii] Meisner, S, Lehur P-A, Moran B, Martin L, Jemec GBE (2012). Peristomal Skin Complications are Common, Expensive, and Difficult to Manage: A Population Based Cost Modeling Study. Plus ONE 7(5): e37813.