Health Economics and Outcome Research (HEOR) Department, HARTMANN GROUP, Heidenheim, Germany.
Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT, Hall, Tirol, Austria.
Int Wound J. 2022 Feb;19(2):447-459. doi: 10.1111/iwj.13645. Epub 2021 Aug 2.
The study aims to estimate the cost-effectiveness of superabsorbent wound dressings compared to the standard-of-care (SoC) dressings mix for treatment of patients with moderate-to-highly exuding leg ulcers in the German healthcare settings. A model-based cost-effectiveness analysis was conducted from the German statutory health insurance perspective, following German specific and international recommendations of good research practice. An individual-level (microsimulation) state-transition model has been used with a cycle length of 1 week and time horizon of 6 months. Several comprehensive systematic reviews were conducted to inform all model inputs, including clinical parameters, efficacy, quality of life, resources utilisation, and cost inputs. In addition, primary data from two clinical trials were used. Based on this cost-effectiveness analysis, using superabsorbent wound dressings instead of the SoC dressings of patients with moderate-to-highly exuding leg ulcers in Germany can lead to an improved healing rate of 2.57% (benefit ratio 1.08), improved health-related quality of life of 0.152 quality-adjusted life weeks, and total direct cost savings of €771 per patient in 6 months. Robustness of results was confirmed in sensitivity and scenario analyses.
本研究旨在评估高吸水性伤口敷料相对于标准治疗(SoC)敷料组合,用于治疗德国医疗保健环境中中度至高度渗出性腿部溃疡患者的成本效益。从德国法定健康保险的角度出发,采用基于模型的成本效益分析,遵循德国特定的和国际上良好研究实践的建议。采用个体水平(微观模拟)状态转移模型,周期长度为 1 周,时间范围为 6 个月。进行了多项全面的系统评价,为所有模型输入提供信息,包括临床参数、疗效、生活质量、资源利用和成本输入。此外,还使用了两项临床试验的原始数据。基于这项成本效益分析,在德国,使用高吸水性伤口敷料代替中度至高度渗出性腿部溃疡患者的 SoC 敷料,可以将愈合率提高 2.57%(效益比 1.08),提高 0.152 个质量调整生命周的健康相关生活质量,并在 6 个月内每个患者的直接总成本节省 771 欧元。敏感性和情景分析证实了结果的稳健性。