Diabetes can lead to nerve damage in the foot, causing the wasting of muscle and a loss of feeling. This, combined with increased pressure from shoes, a foot deformity or trauma to the foot, contributes to the development of foot ulcers. Foot ulcers can lead to disease and put people at risk for amputation of the foot or leg.
Devices that reduce pressure in the foot, called "pressure offloading devices," are an important way to treat foot ulcers by removing the pressure points that lead to or exacerbate foot ulcers. These devices include: fibreglass total contact casting, removable cast walkers, and irremovable cast walkers.
Health Quality Ontario Reviews Fibreglass Total Contact Casting, Removable Cast Walkers, and Irremovable Cast Walkers to Treat Diabetic Neuropathic Foot Ulcers
In Ontario in 2015, there were approximately 1.5 million people with diabetes. Estimates indicate that 2% to 3% of people with diabetes experience a foot ulcer each year. Devices that assist in reducing pressure improved ulcer healing. However, cost, comfort, and convenience are concerns for patients.
The 5-year budget impact of fully funding total contact casting, removable cast walkers, and irremovable cast walkers would be $17 to $20 million per year. However, the health system would be expected to save money because fewer people would need amputations.
The Ministry of Health and Long-Term Care has accepted this recommendation.
The Ministry of Health and Long-Term Care has provided the following response: Starting in 2017-18 new funding has been provided to the Local Health Integration Networks and to Aboriginal Health Access Centres to provide support for pressure offloading devices for diabetic foot ulcers in the appropriate settings where these devices are accessed by patients.