Modelling the relative cost-effectiveness of amelogenin in non-healing venous leg ulcers

Guest, J. F., Nagy, E., Sladkevicius, E., Vowden, P. and Price, Patricia Elaine 2009. Modelling the relative cost-effectiveness of amelogenin in non-healing venous leg ulcers. Journal of Wound Care 18 (5) , pp. 216-224.

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Abstract

OBJECTIVE: To assess the cost-effectiveness of using amelogenin plus compression bandaging versus compression bandaging alone in treating non-healing venous leg ulcers (VLUs) of over six months duration, from the perspective of the national health service in England. METHOD: A 12-month Markov model was constructed that depicted the management of a chronic, non-healing VLU of over six months duration. The model considers the decision by a clinician to treat a recalcitrant VLU with amelogenin plus compression bandaging or compression bandaging alone, and was used to estimate the relative cost-effectiveness of amelogenin plus compression bandaging at 20062007 prices. RESULTS: According to the model, 60% of all wounds treated with amelogenin plus compression bandaging are expected to heal within 12 months of the start of treatment compared with 41% of wounds treated with compression bandaging alone (p<0.01). Additionally, 23% of all amelogenin-treated wounds are expected to improve compared with 18% of wounds in the compression bandaging alone group. This difference in effectiveness between the two groups is expected to lead to a 7% improvement in health gain among amelogenin-treated patients when compared with those treated with compression bandaging alone (0.800 versus 0.746 QALYs; p<0.01) at 12 months after the start of treatment. Use of amelogenin is expected to lead a 10% reduction in NHS cost over 12 months from pound4,261 (95% CI: pound3,409; pound5,114) to pound3,816 (95% CI: pound3,227; pound4,405), due in part to a reduction in the requirement for nurse visits. Hence, amelogenin plus compression bandaging was found to be a dominant treatment. Moreover, use of amelogenin is expected to free-up NHS resources for alternative use within the system. CONCLUSION: Within the models limitations, amelogenin plus compression bandaging is expected to afford the NHS a cost-effective dressing compared with compression bandaging alone in the management of chronic non-healing VLUs of more than six months duration. Declaration of interest: This study was sponsored by Mölnlycke Heath Care. The authors have no other conflicts of interest that are directly relevant to the content of this manuscript.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Schools > Healthcare Sciences
Subjects:	R Medicine > R Medicine (General) R Medicine > RT Nursing
Publisher:	Mark Allen Publishing Ltd
ISSN:	0969-0700
Last Modified:	04 Jun 2017 04:02
URI:	https://orca.cardiff.ac.uk/id/eprint/31441

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