Centre for Health Social Care, Faculty of Health and Wellbeing, Sheffield Hallam University, UK; B. Braun Medical UK, Sheffield, UK.
Leeds Institute of Health Sciences, University of Leeds, UK.
J Tissue Viability. 2023 May;32(2):262-269. doi: 10.1016/j.jtv.2023.03.001. Epub 2023 Mar 16.
Wounds cost £8.3 billion per year in the United Kingdom (UK) annually. Venous leg ulcers (VLUs) account for 15% of wounds and can be complicated to heal, increasing nurse visits and resource costs. Recent wound bed preparation consensus recommends wound cleansing and biofilm disrupting agents. However, inert cleansers such as tap water or saline are inexpensive, an evaluation of evidence is required to justify the higher upfront costs of treatment with active cleansers. We undertook a cost-effectiveness analysis of the use of a biofilm disrupting and cleansing solution and gel, Prontosan® Solution and Gel X, (PSGX) (B Braun Medical), as compared to the standard practice of using saline solution, for treating VLUs.
A Markov model was parameterised to one-year costs and health-related quality of life consequences of treating chronic VLUs with PSGX versus saline solution. Costs are viewed from a UK healthcare payer perspective, include routine care and management of complications. A systematic literature search was performed to inform the clinical parameters of the economic model. Deterministic univariate sensitivity analysis (DSA) and probabilistic sensitivity analysis (PSA) were undertaken.
For PSGX an Incremental Net Monetary Benefit (INMB) of £1,129.65 to £1,042.39 per patient (with a Maximum Willingness to Pay of £30k and £20k per QALY respectively), of which cost savings are £867.87 and 0.0087 quality-adjusted life years (QALYs) gain per patient. PSA indicates a 99.3% probability of PSGX being cost-effective over saline.
PSGX for the treatment of VLUs is dominant compared with saline solution in the UK with expected cost-savings within a year and improved patient outcomes.
在英国，每年伤口治疗费用高达 83 亿英镑。静脉溃疡（VLUs）占伤口的 15%，且难以愈合，增加了护士访视次数和资源成本。最近的伤口床准备共识建议进行伤口清洁和生物膜破坏剂处理。然而，自来水或生理盐水等惰性清洁剂价格低廉，需要评估证据以证明使用活性清洁剂治疗的前期成本更高是合理的。我们对使用生物膜破坏和清洁溶液和凝胶（Prontosan® Solution and Gel X，PSGX）（B Braun Medical）与生理盐水标准治疗方案治疗静脉溃疡（VLUs）的成本效益进行了分析。
使用 Markov 模型对使用 PSGX 与生理盐水治疗慢性 VLUs 的一年成本和健康相关生活质量后果进行了参数化。成本从英国医疗保健支付者的角度考虑，包括常规护理和并发症管理。进行了系统的文献检索，为经济模型的临床参数提供信息。进行了确定性单变量敏感性分析（DSA）和概率敏感性分析（PSA）。
对于 PSGX，每位患者的增量净货币收益（INMB）为 1129.65 英镑至 1042.39 英镑（最大意愿支付分别为 30 千英镑和 20 千英镑/每 QALY），其中节省的成本为 867.87 英镑和 0.0087 个质量调整生命年（QALY）每位患者的收益。PSA 表明，PSGX 在英国治疗 VLUs 的成本效益比生理盐水高 99.3%。
PSGX 治疗 VLUs 比生理盐水在英国具有优势，预计一年内可节省成本，并改善患者预后。
