Lymphedema within the healthcare system

Lymphedema impacts psychological, psychosocial, and physiological aspects in the person experiencing this chronic condition. Lymphedema symptoms and the burden of their management further exact an economic toll on individuals, families, society, and the healthcare system. A review of the published literature addressing lymphedema costs, outcomes, and impacts is summarized, with recommendations on approaches to enhance patient outcomes in the millions affected and temper economic sequelae. Primary and secondary lymphedema remains incurable in modern medicine, leading to its categorization as a chronic illness requiring both professional and self-management. Due to associated psychological, psychosocial, and physiological symptoms and deficits in function and productivity, lymphedema exerts substantial economic burden for patients, payers, and the healthcare system as a whole. Economic evaluation includes four cost categories: health sectors, other sectors, patient/family, and productivity losses (known as indirect costs). Although published research in the realm of economics and the healthcare system is limited, most of the reported work has been done in the health sector. Coverage by payers in the United States is limited, differs by insurance plans, and may vary by geographic location and population characteristics. Early detection and treatment through prospective surveillance are shown to be effective in reducing impact on economic and healthcare resources. Research is needed to further examine relationships and interactions among the variables of the identified models, including comparison of costs and outcomes related to primary and secondary lymphedema.