Cost-effectiveness of TLC-sucrose octasulfate versus control dressings in the treatment of diabetic foot ulcers
| Autor: | Reinhard Rychlik, Cornelia Fietz, Wolfgang Tigges, Holger Lawall, Ralf Lobmann, Matthias Augustin, Helena Thiem, Christoph Potempa |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Sucrose medicine.medical_specialty Nursing (miscellaneous) Cost effectiveness Cost-Benefit Analysis 030209 endocrinology & metabolism 030207 dermatology & venereal diseases 03 medical and health sciences Wound care Indirect costs 0302 clinical medicine Double-Blind Method Sucrose octasulfate Diabetes mellitus Internal medicine medicine Humans business.industry Middle Aged Anti-Ulcer Agents medicine.disease Diabetic foot Diabetic Foot Europe Treatment Outcome Diabetic foot ulcer Diabetes Mellitus Type 2 Female Fundamentals and skills business Bandages Hydrocolloid |
| Zdroj: | Journal of Wound Care. 28:808-816 |
| ISSN: | 2052-2916 0969-0700 |
| DOI: | 10.12968/jowc.2019.28.12.808 |
| Popis: | Objective: Diabetes is one of the most widespread diseases in Germany. Common complications are diabetic foot ulcers (DFU), which are associated with a cost-intensive treatment and serious adverse events, such as infections, amputations. This cost-effectiveness analysis compares two treatment options for patients with DFU: a TLC-NOSF dressing versus a neutral dressing, assessed through a European double-blind randomised controlled trial (RCT), Explorer. Methods: The evaluation of the clinical outcomes was associated to direct costs (costs for dressings, nursing time, hospitalisation etc.) of both dressings, from the perspective of the statutory health insurance in Germany. Due to the long mean healing time of a DFU, the observation period was extended from 20 to 100 weeks in a Markov model. Results: After 20 weeks, and with complete closure as a primary endpoint, the model revealed direct treatment costs for DFU of €2,864.21 when treated with a TLC-NOSF dressing compared with €2,958.69 with the neutral control dressing (cost-effectiveness: €6,017.25 versus €9,928.49). In the Markov model (100 weeks) the costs for the TLC-NOSF dressing were €5,882.87 compared with €8,449.39 with the neutral dressing (cost-effectiveness: €6,277.58 versus €10,375.56). The robustness of results was underlined by several sensitivity analyses for varying assumptions. The frequency of weekly dressing changes had the most significant influence in terms of parameter uncertainty. Conclusion: Overall, the treatment of DFU with a TLC-NOSF dressing is supported from a health economic perspective, because both the treatment costs and the cost-effectiveness were superior compared with the neutral wound dressing. |
| Databáze: | OpenAIRE |
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