York Trials Unit, Department of Health Sciences, University of York, Heslington, York, UK.
Int Wound J. 2011 Feb;8(1):22-32. doi: 10.1111/j.1742-481X.2010.00739.x. Epub 2010 Sep 28.
The objective of the study was to assess the cost-effectiveness of Vacuum Assisted Closure® (V.A.C.®) Therapy compared with advanced wound care (AWC) for the treatment of diabetic foot ulcers (DFUs) in France. A cost-effectiveness model intended to reflect the management of DFUs was updated for the French setting. The Markov model follows the progression of 1000 hypothetical patients over a 1-year period. The model was populated with French-specific data, obtained from published sources and clinical experts. The analysis evaluated costs and health outcomes, in terms of quality-adjusted life-years (QALYs), wounds healed and amputations, from the perspective of the payer. The patients treated with V.A.C.® Therapy experienced more QALYs (0.787 versus 0.784) and improved healing rates (50.2% versus 48.5%) at a lower total cost of care (€24,881 versus €28,855 per patient per year) when compared with AWC. Sensitivity analyses conducted around key model parameters indicated that the results were affected by hospital resource use and costs. DFU treatment using V.A.C.® Therapy in France was associated with lower costs, additional QALYs, more healed ulcers and fewer amputations than treatment with AWC. V.A.C.® Therapy was therefore found to be the dominant treatment option.
本研究旨在评估在法国，与高级创面护理（AWC）相比，负压伤口疗法（V.A.C.®疗法）治疗糖尿病足溃疡（DFU）的成本效益。针对法国情况，更新了旨在反映 DFU 管理的成本效益模型。Markov 模型跟踪了 1000 名假设患者在 1 年内的进展情况。该模型使用从已发表的来源和临床专家获得的法国特定数据进行填充。该分析从付款人的角度评估了成本和健康结果，即质量调整生命年（QALYs）、愈合的伤口和截肢，用于治疗 V.A.C.®疗法的患者具有更高的 QALYs（0.787 比 0.784）和更高的愈合率（50.2%比 48.5%），而总护理成本更低（每位患者每年 24881 欧元比 28855 欧元）与 AWC 相比。对关键模型参数进行的敏感性分析表明，结果受医院资源使用和成本的影响。与 AWC 治疗相比，法国使用 V.A.C.®疗法治疗 DFU 可降低成本、增加 QALYs、更多愈合的溃疡和更少的截肢，因此被认为是更优的治疗选择。
