A cost-effectiveness analysis of a hydration response technology dressing in the treatment of venous leg ulcers in the UK

Stefan Walzer, D Droschel, L Vollmer, Leanne Atkin, Karen Ousey

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: Venous leg ulcers (VLUs) cause significant pain and suffering for patients. Additionally, they place considerable financial and service burden on the National Health Service (NHS). A large proportion of VLUs do not heal within the standard time frame of 1624 weeks, resulting in static wounds which commonly have issues with increasing exudate production. As the NHS continues to face times of austerity, services need to find solutions to be able to reduce costs and release nursing time while maintaining standards of care. Cutimed Sorbion Sachet S, a hydration response technology dressing (HRTD), is a treatment option for the management of patients with a VLU. The objective of this study was to provide an update of the health economic analysis of HRTD in comparison with relevant comparators in the UK with current cost data. Method: HRTD was compared against four different dressings, Zetuvit Plus (a super absorbent polymer dressing SAP), DryMax extra (a superabsorbent dressing, SADM), KerraMax Care (superabsorbent dressing, SAKM) and Eclypse (superabsorbent dressing, SAE) from a cost-effectiveness perspective. Clinical data were derived from literature and expert opinion. Cost input was utilised based on publicly available data and literature. The average patient in the model is assumed to be 65 years with a diagnosed VLU. It is assumed that patients in the different treatment arms have the same background mortality, hence the endpoint mortality is not included in the model. The analysis is based on a deterministic Markov model derived from Harding et al. with weekly cycles. The following assumptions are made: first, all patients start in a static health state with a non-healed but non-progressing VLU. It is assumed in the model that patients wounds can transition to a deteriorating state or one where a wound is improving or could progress. Additionally, VLUs could be healed from a progressed wound (i.e. improved wound), or they could develop into a severe wound with complications (infections) to be treated in hospitals. The time frame for the analysis was fixed for one year and no re-occurence after healing was assumed to happen. Results: The cost-effectiveness analysis demonstrates health economic dominance of HRDT being more effective and cost-saving against all analysed comparators. When using literature-based input values, the incrementally higher healing rates for HRDT are 11.04 months (versus SAP), 29.04 months (versus SADM), 1.68 months (versus SAKM) and 11.04 months (versus SAE). Cost savings per patient were £37.60 versus SAP, £171.68 versus SADM, £3.13 versus SAKM and £43.63 versus SAE. Conclusion: Clinical benefits and cost savings increase when real-life practice assumptions, based on expert opinion, are included. Based on the underlying health economic model, HRDT is more effective and less costly than other comparative products in VLUs in the UK.

Original languageEnglish
Pages (from-to)166-172
Number of pages7
JournalJournal of wound care
Volume27
Issue number3
DOIs
Publication statusPublished - 6 Mar 2018

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Varicose Ulcer
Leg Ulcer
Bandages
Cost-Benefit Analysis
Technology
Wounds and Injuries
Costs and Cost Analysis
Cost Savings
Health
Expert Testimony
National Health Programs
Therapeutics
Economics
Economic Models
Mortality
Exudates and Transudates
Standard of Care
Polymers
Nursing
Pain

Cite this

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title = "A cost-effectiveness analysis of a hydration response technology dressing in the treatment of venous leg ulcers in the UK",
abstract = "Objective: Venous leg ulcers (VLUs) cause significant pain and suffering for patients. Additionally, they place considerable financial and service burden on the National Health Service (NHS). A large proportion of VLUs do not heal within the standard time frame of 1624 weeks, resulting in static wounds which commonly have issues with increasing exudate production. As the NHS continues to face times of austerity, services need to find solutions to be able to reduce costs and release nursing time while maintaining standards of care. Cutimed Sorbion Sachet S, a hydration response technology dressing (HRTD), is a treatment option for the management of patients with a VLU. The objective of this study was to provide an update of the health economic analysis of HRTD in comparison with relevant comparators in the UK with current cost data. Method: HRTD was compared against four different dressings, Zetuvit Plus (a super absorbent polymer dressing SAP), DryMax extra (a superabsorbent dressing, SADM), KerraMax Care (superabsorbent dressing, SAKM) and Eclypse (superabsorbent dressing, SAE) from a cost-effectiveness perspective. Clinical data were derived from literature and expert opinion. Cost input was utilised based on publicly available data and literature. The average patient in the model is assumed to be 65 years with a diagnosed VLU. It is assumed that patients in the different treatment arms have the same background mortality, hence the endpoint mortality is not included in the model. The analysis is based on a deterministic Markov model derived from Harding et al. with weekly cycles. The following assumptions are made: first, all patients start in a static health state with a non-healed but non-progressing VLU. It is assumed in the model that patients wounds can transition to a deteriorating state or one where a wound is improving or could progress. Additionally, VLUs could be healed from a progressed wound (i.e. improved wound), or they could develop into a severe wound with complications (infections) to be treated in hospitals. The time frame for the analysis was fixed for one year and no re-occurence after healing was assumed to happen. Results: The cost-effectiveness analysis demonstrates health economic dominance of HRDT being more effective and cost-saving against all analysed comparators. When using literature-based input values, the incrementally higher healing rates for HRDT are 11.04 months (versus SAP), 29.04 months (versus SADM), 1.68 months (versus SAKM) and 11.04 months (versus SAE). Cost savings per patient were £37.60 versus SAP, £171.68 versus SADM, £3.13 versus SAKM and £43.63 versus SAE. Conclusion: Clinical benefits and cost savings increase when real-life practice assumptions, based on expert opinion, are included. Based on the underlying health economic model, HRDT is more effective and less costly than other comparative products in VLUs in the UK.",
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A cost-effectiveness analysis of a hydration response technology dressing in the treatment of venous leg ulcers in the UK. / Walzer, Stefan; Droschel, D; Vollmer, L; Atkin, Leanne; Ousey, Karen.

In: Journal of wound care, Vol. 27, No. 3, 06.03.2018, p. 166-172.

Research output: Contribution to journalArticle

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T1 - A cost-effectiveness analysis of a hydration response technology dressing in the treatment of venous leg ulcers in the UK

AU - Walzer, Stefan

AU - Droschel, D

AU - Vollmer, L

AU - Atkin, Leanne

AU - Ousey, Karen

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N2 - Objective: Venous leg ulcers (VLUs) cause significant pain and suffering for patients. Additionally, they place considerable financial and service burden on the National Health Service (NHS). A large proportion of VLUs do not heal within the standard time frame of 1624 weeks, resulting in static wounds which commonly have issues with increasing exudate production. As the NHS continues to face times of austerity, services need to find solutions to be able to reduce costs and release nursing time while maintaining standards of care. Cutimed Sorbion Sachet S, a hydration response technology dressing (HRTD), is a treatment option for the management of patients with a VLU. The objective of this study was to provide an update of the health economic analysis of HRTD in comparison with relevant comparators in the UK with current cost data. Method: HRTD was compared against four different dressings, Zetuvit Plus (a super absorbent polymer dressing SAP), DryMax extra (a superabsorbent dressing, SADM), KerraMax Care (superabsorbent dressing, SAKM) and Eclypse (superabsorbent dressing, SAE) from a cost-effectiveness perspective. Clinical data were derived from literature and expert opinion. Cost input was utilised based on publicly available data and literature. The average patient in the model is assumed to be 65 years with a diagnosed VLU. It is assumed that patients in the different treatment arms have the same background mortality, hence the endpoint mortality is not included in the model. The analysis is based on a deterministic Markov model derived from Harding et al. with weekly cycles. The following assumptions are made: first, all patients start in a static health state with a non-healed but non-progressing VLU. It is assumed in the model that patients wounds can transition to a deteriorating state or one where a wound is improving or could progress. Additionally, VLUs could be healed from a progressed wound (i.e. improved wound), or they could develop into a severe wound with complications (infections) to be treated in hospitals. The time frame for the analysis was fixed for one year and no re-occurence after healing was assumed to happen. Results: The cost-effectiveness analysis demonstrates health economic dominance of HRDT being more effective and cost-saving against all analysed comparators. When using literature-based input values, the incrementally higher healing rates for HRDT are 11.04 months (versus SAP), 29.04 months (versus SADM), 1.68 months (versus SAKM) and 11.04 months (versus SAE). Cost savings per patient were £37.60 versus SAP, £171.68 versus SADM, £3.13 versus SAKM and £43.63 versus SAE. Conclusion: Clinical benefits and cost savings increase when real-life practice assumptions, based on expert opinion, are included. Based on the underlying health economic model, HRDT is more effective and less costly than other comparative products in VLUs in the UK.

AB - Objective: Venous leg ulcers (VLUs) cause significant pain and suffering for patients. Additionally, they place considerable financial and service burden on the National Health Service (NHS). A large proportion of VLUs do not heal within the standard time frame of 1624 weeks, resulting in static wounds which commonly have issues with increasing exudate production. As the NHS continues to face times of austerity, services need to find solutions to be able to reduce costs and release nursing time while maintaining standards of care. Cutimed Sorbion Sachet S, a hydration response technology dressing (HRTD), is a treatment option for the management of patients with a VLU. The objective of this study was to provide an update of the health economic analysis of HRTD in comparison with relevant comparators in the UK with current cost data. Method: HRTD was compared against four different dressings, Zetuvit Plus (a super absorbent polymer dressing SAP), DryMax extra (a superabsorbent dressing, SADM), KerraMax Care (superabsorbent dressing, SAKM) and Eclypse (superabsorbent dressing, SAE) from a cost-effectiveness perspective. Clinical data were derived from literature and expert opinion. Cost input was utilised based on publicly available data and literature. The average patient in the model is assumed to be 65 years with a diagnosed VLU. It is assumed that patients in the different treatment arms have the same background mortality, hence the endpoint mortality is not included in the model. The analysis is based on a deterministic Markov model derived from Harding et al. with weekly cycles. The following assumptions are made: first, all patients start in a static health state with a non-healed but non-progressing VLU. It is assumed in the model that patients wounds can transition to a deteriorating state or one where a wound is improving or could progress. Additionally, VLUs could be healed from a progressed wound (i.e. improved wound), or they could develop into a severe wound with complications (infections) to be treated in hospitals. The time frame for the analysis was fixed for one year and no re-occurence after healing was assumed to happen. Results: The cost-effectiveness analysis demonstrates health economic dominance of HRDT being more effective and cost-saving against all analysed comparators. When using literature-based input values, the incrementally higher healing rates for HRDT are 11.04 months (versus SAP), 29.04 months (versus SADM), 1.68 months (versus SAKM) and 11.04 months (versus SAE). Cost savings per patient were £37.60 versus SAP, £171.68 versus SADM, £3.13 versus SAKM and £43.63 versus SAE. Conclusion: Clinical benefits and cost savings increase when real-life practice assumptions, based on expert opinion, are included. Based on the underlying health economic model, HRDT is more effective and less costly than other comparative products in VLUs in the UK.

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KW - Cost-effectiveness

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