Cost-effectiveness of a Ceramide-Infused Skin Barrier Versus a Standard Barrier: Findings From a Long-Term Cost-effectiveness Analysis
| Autor: | Tonny Karlsmark, Gary Inglese, Ariel Berger, George Skountrianos, Mustafa Oguz |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Marginal cost
Quality of Life/psychology medicine.medical_specialty Cost effectiveness Cost-Benefit Analysis Skin Cream Ceramides 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Willingness to pay Quality of life Health care Medicine Humans Advanced and Specialized Nursing Skin Cream/economics Cost–benefit analysis Health Care Costs/statistics & numerical data business.industry Australia Surgical Stomas Cost-effectiveness analysis Health Care Costs Medical–Surgical Nursing Surgical Stomas/adverse effects 030220 oncology & carcinogenesis Emergency medicine Cohort Ceramides/economics Quality of Life Erratum business |
| Zdroj: | Journal of Wound, Ostomy, and Continence Nursing Berger, A, Inglese, G, Skountrianos, G, Karlsmark, T & Oguz, M 2018, ' Cost-effectiveness of a Ceramide-Infused Skin Barrier Versus a Standard Barrier : Findings From a Long-Term Cost-effectiveness Analysis ', WOCN: Journal of Wound, Ostomy and Continence Nursing, vol. 45, no. 2, pp. 146-155 . https://doi.org/10.1097/WON.0000000000000416 |
| ISSN: | 1528-3976 |
| DOI: | 10.1097/WON.0000000000000416 |
| Popis: | PURPOSE: To assess the cost-effectiveness of a ceramide-infused skin barrier (CIB) versus other skin barriers (standard of care) among patients who have undergone ostomy creation.DESIGN: Cost-effectiveness analysis, based on a decision-analytic model that was estimated using data from the ADVOCATE (A Study Determining Variances in Ostomy Skin Conditions And The Economic Impact) trial, which investigated stoma-related healthcare costs over 12 weeks among patients who recently underwent fecal ostomy, and from other sources.SUBJECTS AND SETTING: Analysis was based on a hypothetical cohort of 1000 patients who recently underwent fecal ostomy; over a 1-year period, 500 patients were assumed to use CIB and 500 were assumed to use standard of care.METHODS: We adapted a previous economic model to estimate expected 1-year costs and outcomes among persons with a new ostomy assumed to use CIB versus standard of care. Outcomes of interest included peristomal skin complications (PSCs) (up to 2 during the 1-year period of interest) and quality-adjusted life days (QALDs); QALDs vary from 1, indicating a day of perfect health to 0, indicating a day with the lowest possible health (deceased). Subjects were assigned QALDs on a daily basis, with the value of the QALD on any given day based on whether the patient was experiencing a PSC. Costs included those related to skin barriers, ostomy accessories, and care of PSCs. The incremental cost-effectiveness of CIB versus standard of care was estimated as the incremental cost per PSC averted and QALD gained, respectively; net monetary benefit of CIB was also estimated. All analyses were run using the perspective of an Australian payer.RESULTS: On a per-patient basis, use of CIB was expected over a 1-year period to result in 0.16 fewer PSCs, an additional 0.35 QALDs, and a savings of A$180 (Australian dollars, US $137) in healthcare costs all versus standard of care. Management with CIB provided a net monetary benefit (calculated as the product of maximum willingness to pay for 1 QALD times additional QALDs with CIB less the incremental cost of CIB) of A$228 (US $174). Probabilistic sensitivity analysis was also completed; it revealed that 97% of model runs resulted in fewer expected PSCs with CIB; 92% of these runs resulted in lower expected costs with CIB.CONCLUSIONS: Findings suggest that the CIB is a cost-effective skin barrier for persons living with an ostomy. |
| Databáze: | OpenAIRE |
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