Scanlon Elizabeth, Karlsmark Tonny, Leaper David J, Carter Kate, Poulsen Peter B, Hart-Hansen Kristian, Hahn Tina W
Leeds Teaching Hospitals Trust, St James University Hospital, Leeds, UK.
Int Wound J. 2005 Jun;2(2):150-60. doi: 10.1111/j.1742-4801.2005.00083.x.
The aim of this analysis was to examine the cost-effectiveness of Contreet Foam (A) in comparison with three other commonly used venous leg ulcer treatment protocols: Aquacel Ag (B), Actisorb Silver (C) and Iodoflex (D). A health-economic analysis reflecting the UK treatment practice and cost structure was performed. The analysis was set up to assess the cost of relative wound area reduction over a 4-week treatment period. The model was validated by a UK expert panel consisting of four wound care specialists. To assure that the 4-week model had a realistic link to cost-effectiveness of complete wound healing, a Markov analysis was also performed. Sensitivity analyses were carried out to ensure validity. Protocol A and C proved to be the most effective treatments. The mean relative reduction in wound area after 4 weeks of treatment was 50.2% (protocol A), 23.9% (protocol B), 44.6% (protocol C) and 36.0% (protocol D). Cost-effectiveness ratios showed that protocol A proved to be the most cost-effective treatment, and protocol B the least. The cost per percentage reduction in wound area was 9.50 UK pounds for protocol A, compared to 16.50-17.60 UK pounds for the other treatment options. The cost-effectiveness of complete healing (Markov analysis) and sensitivity analyses confirmed these results. Using Contreet Foam instead of the other dressing alternatives may imply savings of 2.2-4.4 million UK pounds per year to the National Health Service.
本分析的目的是研究康瑞特泡沫敷料(A)与其他三种常用的下肢静脉溃疡治疗方案:水凝胶银离子敷料(B)、活性银离子敷料(C)和碘伏棉垫(D)相比的成本效益。进行了一项反映英国治疗实践和成本结构的卫生经济分析。该分析旨在评估在4周治疗期内相对伤口面积减少的成本。该模型由一个由四名伤口护理专家组成的英国专家小组进行验证。为确保4周模型与完全伤口愈合的成本效益有现实关联,还进行了马尔可夫分析。进行了敏感性分析以确保有效性。方案A和C被证明是最有效的治疗方法。治疗4周后伤口面积的平均相对减少率分别为:方案A为50.2%,方案B为23.9%,方案C为44.6%,方案D为36.0%。成本效益比表明,方案A被证明是最具成本效益的治疗方法,而方案B最不具成本效益。方案A每减少1%伤口面积的成本为9.50英镑,而其他治疗方案的成本为16.50 - 17.60英镑。完全愈合的成本效益(马尔可夫分析)和敏感性分析证实了这些结果。使用康瑞特泡沫敷料而非其他敷料替代品,每年可能为英国国家医疗服务体系节省220万至440万英镑。