Potential Budget Impact of Negative Pressure Wound Therapy (NPWT) Versus Conventional Wound Treatment (CWT) in Diabetic Foot Ulcers (DFU), Surgical Abdominal Wounds with Healing Impairment (SAWHI), and Trauma Wounds for Mexico

OBJECTIVES: To estimate the potential budget impact of adopting negative pressure wound therapy (NPWT) vs conventional wound treatment (CWT) for diabetic foot ulcers (DFU), surgical abdominal wounds with healing impairment (SAWHI), and traumatic wounds in Mexico.

METHODS: A health economic model calculated the potential budget impact using costs attributed to length of therapy (LoT) and length of stay (LoS) from the perspective of public health care in Mexico, only patients receiving in-hospital care were assessed. The model considered average LoT (NPWT vs CWT) of 14.82 versus 44.57 days (DFU), 17.45 versus 32.76 days (trauma), and 22.8 versus 30.6 days (SAWHl). The average LoS (NPWT vs CWT) was 15.86 versus 29.0 days (DFU), 13.55 versus 20.67 days (trauma), and 13.9 versus 11.8 days (SAWHI), from published literature. The overall wound closure rate for SAWHI patients of 47.8% for NPWT compared to 27.6% for CWT. Local material costs were applied. All calculations were performed in local currency and converted to US dollars.

RESULTS: Total cost reduction for 100 patients with DFUs and traumatic wounds using NPWT was $885,512 (44.9%) and $458,778 (32.6%), respectively. In SAWHI patients there was no estimated cost reduction with NPWT, rather an extra cost of -$160,178 (-19.8%). However, when overall wound closure rates are considered, total cost reduction per SAWHI patient with wound closure using NPWT was $160,088 (30.8%).

CONCLUSIONS: NPWT use in DFU and trauma is likely to be cost saving for hospital budgets for Mexico. For patients with SAWHI, additional investment is likely to be required, and should be balanced to the benefits obtained. A Cost-Effectiveness analysis is recommended to position the incremental cost in the perspective of the willingness to pay for the improved health outcome.