Clinical and cost-effectiveness of absorbent dressings in the treatment of highly exuding VLUs

Cutting, Keith, Panca, M. and Guest, J. F. (2013) Clinical and cost-effectiveness of absorbent dressings in the treatment of highly exuding VLUs. Journal of Wound Care, 22 (3). pp. 109-118. ISSN 0969-0700

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Abstract

l Objective: To estimate the clinical effectiveness and cost effectiveness of using a sodium carboxymethylcellulose dressing (CMC [Aquacel]) and four superabsorbent dressings (DryMax Extra [DM], Flivasorb [F], Kerramax [K] and sachet S [S]) in the treatment of highly exuding chronic venous leg ulcers (VLUs) in the UK, from the perspective of the National Health Service (NHS). l Method:A decision model was constructed depicting the patient pathways and associated management of a cohort of 439 patients with highly exuding chronic VLUs of ≥3 months of age. The model was based on the case records of a cohort of matched patients from The Health Improvement Network (THIN) database (a nationally representative database of patients registered with general practitioners (GPs) in the UK) who were treated with one of the five dressings. The model estimated the costs and outcomes of patient management over 6 months and the relative cost-effectiveness of using each dressing. l Results: Patients’ mean age was 73.1 years, and 46% were female. Between 39% and 56% of VLUs healed by 6 months. CMC-treated wounds that remained unhealed increased in size by 43% over the study period, whereas unhealed wounds treated with the other dressings decreased in size by a mean 34%. Consequently, CMC was excluded from the cost-effectiveness analysis. The 6-monthly NHS cost of managing a VLU with S was £3700 per patient, which was 15–28% lower than the cost of managing patients with the other three superabsorbents. Additonally, use of S improved patients’ health status to a greater extent than the other three superabsorbents, since S-treated patients accrued 0.3–3% more QALYs. Starting treatment with S was the preferred strategy followed by DM, K and F in that order. l Conclusion: Within the limitations of the data set, S affords the NHS a cost-effective treatment for managing highly exuding chronic VLUs of ≥3 months of age, compared with DM, F, K and CMC. l Declaration of interest: This study was funded with an unrestricted research grant from Sorbion GmbH & Co. KG, Senden, Germany, manufacturers of sachet S. However, Sorbion did not have any control of the methodology, conduct, results or conclusion of this study, or editorial involvement in this manuscript. The authors have no other conflicts of interest that are directly relevant to the content of this manuscript, which remains their sole responsibility

Item Type:	Article
Divisions:	?? BucksNewUniversity ??
Depositing User:	ULCC Admin
Date Deposited:	12 Jun 2013 15:46
Last Modified:	11 Dec 2017 19:18
URI:	https://bnu.repository.guildhe.ac.uk/id/eprint/9596

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