Health Analytical Solutions Ltd, Macclesfield, UK.
Int Wound J. 2024 Oct;21(10):e70048. doi: 10.1111/iwj.70048.
This study evaluates the cost-effectiveness of the geko device a neuromuscular electro-stimulator technology with standard of care (SoC) versus SoC alone for venous leg ulcer (VLU) treatment, from the UK National Health Service (NHS) perspective over 12 months. Research was conducted across NHS UK facilities, primarily within community services and outpatient leg ulcer clinics, encompassing a total of 51 patients. A partitioned survival model, based on a two-arm randomised controlled trial, assessed wound healing rates using Kaplan-Meier curves and parametric extrapolations over a 12-month time horizon. Costs were derived from UK reference costs the British National Formulary, and the Personal Social Services Research Unit (2021/22). The primary outcome measured was the incremental cost per quality-adjusted life-year gained. The geko device provides additional benefits by stimulating the lateral popliteal nerve, augmenting venous, arterial, and microvascular flow. The addition of the geko device to SoC significantly enhanced outcomes, increasing healing probability by 68% compared to SoC. This integration would result in a cost saving of £774.14 per patient when compared to the SoC alone across the NHS. Economic analyses indicate that integrating the geko device into SoC protocols would reduce the overall NHS expenditure on VLU wound management by as much as 15%. The approach also positively impacted health-related quality of life. The geko™ device when used adjunctively with SoC would be a cost-effective method for managing chronic VLUs within the NHS, improving healing rates and offering economic benefits.
本研究从英国国家医疗服务体系(NHS)的角度评估了 geko 设备(一种神经肌肉电刺激技术)联合标准治疗(SoC)与单独 SoC 治疗静脉性下肢溃疡(VLU)的成本效益,评估期为 12 个月。研究在 NHS 英国医疗机构中进行,主要在社区服务和门诊下肢溃疡诊所,共纳入 51 名患者。采用基于双臂随机对照试验的分割生存模型,使用 Kaplan-Meier 曲线和参数外推法评估 12 个月内的伤口愈合率。成本来自英国参考成本(英国国家处方集)和个人社会服务研究单位(2021/22 年)。主要结果是增量成本每获得的质量调整生命年。geko 设备通过刺激外侧腓总神经,增加静脉、动脉和微血管血流,提供额外的益处。与单独 SoC 相比,将 geko 设备添加到 SoC 中可显著提高治疗效果,将愈合概率提高 68%。与单独使用 SoC 相比,在 NHS 中,每位患者的成本节约为 774.14 英镑。经济分析表明,将 geko 设备整合到 SoC 方案中可将 NHS 对 VLU 伤口管理的总支出减少多达 15%。该方法还对健康相关的生活质量产生积极影响。在 NHS 中,geko™设备作为 SoC 的辅助手段,是一种管理慢性 VLU 的具有成本效益的方法,可提高愈合率并带来经济效益。