Health Economics
Despite compression therapy being the gold standard of care for venous leg ulcers (VLUs), patient compliance with four-layer compression bandage (4LB) systems is poor. A novel two-layer bandage (2LB) system, , has been shown to improve wound closure rates. However, the 2LB system is more costly than commonly available 4LB systems. The objective this study was to estimate the cost-effectiveness (CEA) the 2LB system compared to 4LB to heal one additional VLU.
Methods:
A patient-level microsimulation model was used to conduct a cost-effectiveness analysis from the US health system perspective. All clinical data was obtained from a prospective clinical trial.1 The cost data were obtained from a structured literature review and pragmatic meta-analysis adjusted to 2021 USD using the Consumer Price Index. The effect measure was the avoidance of a VLU. The primary outcome was the incremental cost-effectiveness ratio (ICER). Deterministic and probabilistic sensitivity analyses (PSA) were performed to gauge the robustness and reliability of the results.
Results:
The incremental cost-effectiveness ratio was $1,168 per VLU wound healed. In others, one would expect to pay $1,168 more with the 2LB system to heal one additional wound versus the 4LB system. For every 100 patients, the additional cost of a 2LB system was expected to be $6,255 and 5 additional wounds will be healed compared to a 4LB system. Accounting for the savings from the additional wounds healed, these findings resulted in a savings of $16,580 for every 100 patients treated. The sensitivity analyses found the results to be robust to parameter uncertainty.
Discussion:
The 2LB system was a cost-effective strategy for the treatment of VLUs compared to a 4LB system. Further, the 2LB system was shown to increase patient satisfaction.1 Adoption of the 2LB should be considered a value-added adjunct to the management of VLUs.
Trademarked Items: Urgo K2
References: 1. Lazareth I, Moffatt C, Dissemond J. et al. Efficacy of Two Compression Systems in the Management of VLUs: Results from a European RCT. J Wound Care. 2012;21(11):555-565.