Biomaterial Database

Cost-effectiveness of Debrichem in managing hard-to-heal venous leg ulcers in the UK. 2022

Julian F Guest, and Valter Deanesi, and Arrigo Segalla

Catalyst Consultants, Poole, UK.

To estimate whether the topical debriding agent, Debrichem, could potentially afford the UK's National Health Service (NHS) a cost-effective intervention for the management of hard-to-heal venous leg ulcers (VLUs). A Markov model was constructed depicting the management of hard-to-heal VLUs with Debrichem plus standard care (SC) or SC alone over a period of 12 months. The model was populated with inputs from an indirect comparison of two propensity score-matched cohorts. The model estimated the cost-effectiveness of the two interventions in terms of the incremental cost per quality-adjusted life year (QALY) gained at 2019/20 prices. Addition of Debrichem to a SC protocol to treat hard-to-heal VLUs was found to increase the probability of healing by 75% (from 0.35 to 0.61) by 12 months, and to increase health-related quality of life over 12 months from 0.74 to 0.84 QALYs per patient. The 12-month cost of treatment with Debrichem plus SC (£3128 per patient) instead of SC alone (£7195 per patient) has the potential to reduce the total NHS cost of wound management by up to 57%. Hence, Debrichem was estimated to improve health outcomes for less cost. Sensitivity analysis showed that Debrichem plus SC remained a cost-effective (dominant) treatment with plausible variations in costs and effectiveness. Within the limitations of the study, the addition of Debrichem to a SC protocol potentially affords a cost-effective treatment to the NHS for managing hard-to-heal VLUs.

UI	MeSH Term	Description	Entries
D007871	Leg Ulcer	Ulceration of the skin and underlying structures of the lower extremity. About 90% of the cases are due to venous insufficiency (VARICOSE ULCER), 5% to arterial disease, and the remaining 5% to other causes.	Leg Ulcers,Ulcer, Leg,Ulcers, Leg
D011788	Quality of Life	A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral, social environment as well as health and disease.	HRQOL,Health-Related Quality Of Life,Life Quality,Health Related Quality Of Life
D003362	Cost-Benefit Analysis	A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. In contrast a cost effectiveness in general compares cost with qualitative outcomes.	Cost and Benefit,Cost-Benefit Data,Benefits and Costs,Cost Benefit,Cost Benefit Analysis,Cost-Utility Analysis,Costs and Benefits,Economic Evaluation,Marginal Analysis,Analyses, Cost Benefit,Analysis, Cost Benefit,Analysis, Cost-Benefit,Analysis, Cost-Utility,Analysis, Marginal,Benefit and Cost,Cost Benefit Analyses,Cost Benefit Data,Cost Utility Analysis,Cost-Benefit Analyses,Cost-Utility Analyses,Data, Cost-Benefit,Economic Evaluations,Evaluation, Economic,Marginal Analyses
D006113	United Kingdom	Country in northwestern Europe including Great Britain and the northern one-sixth of the island of Ireland, located between the North Sea and north Atlantic Ocean. The capital is London.	Great Britain,Isle of Man
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013222	State Medicine	A system of medical care regulated, controlled and financed by the government, in which the government assumes responsibility for the health needs of the population.	National Health Service, British,Socialized Medicine,British Health Service, National,British National Health Service,Medicine, Socialized,Medicine, State,Service, British National Health
D014647	Varicose Ulcer	Skin breakdown or ulceration in the drainage area of a VARICOSE VEIN, usually in the leg.	Stasis Ulcer,Venous Ulcer,Venous Hypertension Ulcers,Venous Stasis Ulcers,Hypertension Ulcer, Venous,Hypertension Ulcers, Venous,Stasis Ulcer, Venous,Stasis Ulcers,Stasis Ulcers, Venous,Ulcer, Stasis,Ulcer, Varicose,Ulcer, Venous,Ulcer, Venous Hypertension,Ulcer, Venous Stasis,Ulcers, Stasis,Ulcers, Varicose,Ulcers, Venous,Ulcers, Venous Hypertension,Ulcers, Venous Stasis,Varicose Ulcers,Venous Hypertension Ulcer,Venous Stasis Ulcer,Venous Ulcers