Cost-effectiveness of using intermittent pneumatic compression to manage hard-to-heal venous leg ulcers in the UK. (2nd July 2021)

• Record Type: Journal Article
• Authors: Guest, Julian F; Staines, Karen; Murphy, Nina
• Is Part Of: Journal of wound care. Volume 30:Number 7(2021)
• Page Start: 544
• Page End: 552
• Publication Date: 2021-07-02
• Subjects: compression -- cost-effectiveness -- health economics -- infection -- intermittent pneumatic compression (IPC) -- UK -- ulcer -- venous -- venous leg ulcer -- wound; Wounds and injuries -- Treatment -- Periodicals; Wound healing -- Periodicals; 617.1
• DOI: 10.12968/jowc.2021.30.7.544
• Languages: English
• ISSNs: 0969-0700

Abstract

Abstract : Objective: To estimate whether thigh-administered intermittent pneumatic compression (IPC) could potentially afford the UK's National Health Service (NHS) a cost-effective intervention for the management of hard-to-heal venous leg ulcers (VLUs). Method: A Markov model was constructed depicting the management of hard-to-heal VLUs with IPC plus standard care or standard care alone over a period of 24 weeks. The model estimated the cost-effectiveness of the two interventions in terms of the incremental cost per quality-adjusted life year (QALY) gained at 2019/20 prices. Results: Treatment of hard-to-heal VLUs with IPC plus standard care instead of standard care alone is expected to increase the probability of healing by 58% (from 0.24 to 0.38) at 24 weeks and increase health-related quality of life over 24 weeks from 0.32 to 0.34 QALYs per patient. Additionally, the cost of treating with IPC plus standard care (£3, 020 per patient) instead of standard care alone (£3, 037 per patient) has the potential to be cost-neutral if use of this device is stopped after 6 weeks in non-improving wounds. Sensitivity analysis showed that the relative cost-effectiveness of IPC plus standard care remains <£20, 000 per QALY with plausible variations in costs and effectiveness. Conclusion: Within the limitations of this study, the addition of IPC to standard care potentially affords a cost-effective treatment to the NHS for managing hard-to-heal VLUs. However, a controlled study is required to validate the outcomes of this analysis.