Management of Moderate-to-Highly Exuding Leg Ulcers with Polyacrylate Dressings vs. Foam Dressings in Spanish Settings: An Early Stage Cost-Effectiveness and Budget-Impact Analysis
Author(s)
Vladica M. Velickovic, PhD, MD1, Joan-Enric Torra i Bou, MD, PhD2, Francisco Cegri, MD, PhD3, Federico Palomar Llatas, MD, PhD4.
1Head of Evidence Generation, Hartmann group, Neu-Ulm, Germany, 2Facultat d’Infermería i Fisoteràpia, Universitat de Lleida, Campus d’Igualada, Lleida, Spain, 3Sant Martí de Provençals (ICS), Barcelona, Spain, 4Cátedra de Integridad y Cuidados de la Piel, Universidad Católica de Valencia, Valencia, Spain.
1Head of Evidence Generation, Hartmann group, Neu-Ulm, Germany, 2Facultat d’Infermería i Fisoteràpia, Universitat de Lleida, Campus d’Igualada, Lleida, Spain, 3Sant Martí de Provençals (ICS), Barcelona, Spain, 4Cátedra de Integridad y Cuidados de la Piel, Universidad Católica de Valencia, Valencia, Spain.
OBJECTIVES: To evaluate, from the perspective of the Spanish National Health Service, the cost-effectiveness and budgetary impact of polyacrylate dressings versus foam dressings in patients with moderate-to-highly exuding leg ulcers.
METHODS: We employed a decision-analytic microsimulation state-transition model to compare two treatment strategies over a six-month horizon. Patient characteristics were drawn from individual patient data in two clinical trials (n=84), with 1,000 patient profiles simulated per arm. Transition probabilities were informed by systematic literature review and meta-analysis. Costs for health states were derived using Spanish unit costs and calibrated via Harding’s methodology; dressing costs were applied separately. Health outcomes were expressed as quality-adjusted life weeks (QALWs) and healing rates. Deterministic (OWSA) and probabilistic sensitivity analyses (PSA; 5,000 iterations) assessed parameter uncertainty. A willingness-to-pay threshold of €25,000 per QALY (adjusted to QALWs) was applied.
RESULTS: Polyacrylate dressing dressings yielded a 2.41% higher healing rate and an incremental 0.135 QALWs (≈1 extra perfect-health day) per patient over six months, at a mean cost saving of €729 per patient. At the population level (using an incidence of 2.1/1,000 and 2023 census data), full substitution could save approximately €51.3 million annually. PSA indicated polyacrylate dressings were dominant (more effective, less costly) in 100% of simulations; OWSA maintained robustness across all parameter ranges.
CONCLUSIONS: In Spanish healthcare settings, polyacrylate dressing dressings for moderate-to-highly exuding leg ulcers are both more effective and cost-saving compared with conventional foam dressings over six months. These findings support clinical guidelines recommending polyacrylate dressing as first-line therapy for highly exuding leg ulcers and provide robust economic evidence to inform procurement and reimbursement decisions within the Spanish NHS.
METHODS: We employed a decision-analytic microsimulation state-transition model to compare two treatment strategies over a six-month horizon. Patient characteristics were drawn from individual patient data in two clinical trials (n=84), with 1,000 patient profiles simulated per arm. Transition probabilities were informed by systematic literature review and meta-analysis. Costs for health states were derived using Spanish unit costs and calibrated via Harding’s methodology; dressing costs were applied separately. Health outcomes were expressed as quality-adjusted life weeks (QALWs) and healing rates. Deterministic (OWSA) and probabilistic sensitivity analyses (PSA; 5,000 iterations) assessed parameter uncertainty. A willingness-to-pay threshold of €25,000 per QALY (adjusted to QALWs) was applied.
RESULTS: Polyacrylate dressing dressings yielded a 2.41% higher healing rate and an incremental 0.135 QALWs (≈1 extra perfect-health day) per patient over six months, at a mean cost saving of €729 per patient. At the population level (using an incidence of 2.1/1,000 and 2023 census data), full substitution could save approximately €51.3 million annually. PSA indicated polyacrylate dressings were dominant (more effective, less costly) in 100% of simulations; OWSA maintained robustness across all parameter ranges.
CONCLUSIONS: In Spanish healthcare settings, polyacrylate dressing dressings for moderate-to-highly exuding leg ulcers are both more effective and cost-saving compared with conventional foam dressings over six months. These findings support clinical guidelines recommending polyacrylate dressing as first-line therapy for highly exuding leg ulcers and provide robust economic evidence to inform procurement and reimbursement decisions within the Spanish NHS.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE571
Topic
Economic Evaluation, Health Technology Assessment, Medical Technologies
Topic Subcategory
Budget Impact Analysis
Disease
Injury & Trauma, Sensory System Disorders (Ear, Eye, Dental, Skin)