December is our busiest month for patients requesting procedures. There is a mad rush to get all medical procedures done before the end of the year since many people have met their deductible. In essence, their vein care is basically considered a freebie. This timing makes me consider the timing of varicose vein treatment and it just so happens there are recent research papers that address this question.
So, when should you get your varicose veins treated? Is it more expensive to get treated sooner than later or vice versa? Before we answer that, let’s look at how expensive chronic venous disorders are in the United States? You may be shocked to learn that the annual direct medical cost of this ailment in the United States is estimated to be as high as $1 billion!
This makes sense since varicose veins and related conditions are a common problem. Chances are, you possess, or you know someone with varicose veins. Up to 25% of women and 15% of men suffer from the disorder and as we age the risk continues to increase. It is estimated that approximately 11 million men and 22 million women older than 40 years of age are affected by the disease.
While occasionally varicose veins do not cause symptoms, more often than not, symptoms have a significant impact on quality of life (QOL), work productivity, and causes significant disability. Unfortunately, there is a perception that varicose veins are primarily a cosmetic issue and this may delay appropriate therapy.
Over time, untreated varicose veins may worsen and lead to hemorrhage, superficial thrombophlebitis, deep vein thrombosis (DVT), and, ultimately, leg ulcers. One study found that nearly 30% of patients with visible varicose veins experienced a progression to more serious disease, and other authors have shown that increasing venous disease severity is associated with lower QOL.
Enough stalling…let’s answer the question…
So what is the impact of delaying interventional treatment on varicose vein disease progression, complications, and health care costs in a real-world setting? An interesting article in the Journal of Vascular and Interventional Radiology studied 44,206 adult patients with varicose veins over a 3 year period. They followed these people up to 2 years after diagnosis and placed them into 3 different groups based on timing of interventional therapy:
- early < 2mo
- intemediate > 2 mo. but < 6 mo.
- late > 6mo
They found that each 30 day delay in treatment initiation was associated with a 7% higher risk of disease progression and a 1% increase in costs. Over time this can get costly. This makes sense as other studies have shown that those who suffer from more advanced venous disease usually require more frequent subsequent treatments which adds expense.
At least in this study, early treatment of varicose veins is associated with decreased risk of disease progression and can save you and the insurance carrier’s money.
ref: J Vasc Interv Radiol 2016; 27:58–67