Comparing Costs for Traditional, Single-use Negative Pressure Wound Therapy for Diabetic Foot Ulcers

During a recent economic evaluation, researchers found that single-use negative pressure wound therapy (sNPWT) is more cost-effective than traditional NPWT (tNPWT) for treating patients with venous leg ulcers (VLUs) and diabetic foot ulcers (DFUs).

“Lower extremity ulcers such as VLUs and diabetic foot DFUs have a major clinical and economic impact on patients and providers,” explained study author Robert S Kirsner, MD, University of Miami Hospital and Clinics Wound Center, University of Miami Miller School of Medicine, Miami, FL, and colleagues.

The researchers compared incremental cost and ulcer weeks avoided for a time horizon of 12 and 26 weeks using lower extremity ulcer closure rates from a published randomized controlled trial (n=161) that compared sNPWT with tNPWT. Data for treatment costs was pulled from a similar retrospective cost-minimization, payer prospective study in which US national 2016 Medicare claims data was inflated to reflect 2018 costs and multiplied by 7 to estimate the weekly costs for both sNPWT with tNPWT.

For the purposes of Dr Kirsner’s and colleagues’ study, “a hypothetical cohort of patients began in the open ulcer health state, and at the end of each weekly cycle a proportion of the cohort moved into the closed ulcer health state according to a constant transition probability.”

Costs for each treatment arm were summed to note total costs and then the difference was  calculated separately for both VLUs and DFUs. Effectiveness was calculated by noting the incidence of healing at 12 and 26 weeks and the total number of open ulcer weeks; the incremental effectiveness was calculated as sNPWT effectiveness minus tNPWT effectiveness, the researchers explained.

According to the results, over 12 weeks, sNPWT saved approximately $7756 per patient and reduced ulcer incidence by 1.67 ulcer weeks per patient. At 26 weeks, cost savings amounted to $15,749 and 5.31 open ulcer weeks.

“Probabilistic analysis at 26 weeks showed 99.8% of the simulations resulted in sNPWT dominating tNPWT,” noted Dr Kirsner and colleagues. “Scenario analyses showed that sNPWT remained dominant over tNPWT (cost reductions over 26 weeks of $2536 and $7976 per patient, respectively).”

“Using sNPWT for VLUs and DFUs is likely to be more cost-effective than tNPWT from the US payer perspective and may provide an opportunity for policymakers to reduce the economic burden of lower extremity ulcers,” concluded the researchers.

—Edan Stanley 

Reference:
Kirsner RS, Delhougne G, Searle RJ. A Cost-Effectiveness Analysis Comparing Single-use and Traditional Negative Pressure Wound Therapy to Treat Chronic Venous and Diabetic Foot Ulcers. Wound Manag Prev. 2020;66(3):30–36.