OBJECTIVES: To evaluate the cost-effectiveness of chronic venous leg ulcers treatment with a bio-cellulose wound dressing (BWD) compared to the standard treatment with silver sulfadiazine from the perspective of the Brazilian public health system (SUS).

METHODS: From the 2010 Brazilian census, the target population was estimated based on age-stratified incidence of venous ulcers, considering the possibility of relapses as well as the higher incidence in patients with diabetes. The costs were calculated considering BWD changes every seven days and daily exchange of the standard wound dressing. The benefit was determined from a relative risk of 0.72 for complete wound healing for an average time of 84 days and annual gain in QALY of 0.03. Costs data were obtained from a governmental price bank in the year 2016. For the analysis, a decision tree model was built and a probabilistic sensitivity analysis was performed. The amounts were converted into US dollars (1 BRL = 3.25 USD) on 01/03/2018.

RESULTS: The cost of BWD changes was USD 206.56 and USD 30.06 for the standard. An annual cost of USD 1991.37 and USD 2556.14 respectively for the BWD and the standard treatment were estimated by considering dressing replacement time and average healing time. Bio-cellulose dressing was the dominant treatment in cost effectiveness analysis, with only 9% of non-dominance in the probabilistic sensitivity simulations.

CONCLUSIONS: The bio-cellulose wound dressing treatment was more cost-effective for the complete healing of chronic venous leg ulcers compared to the standard treatment with silver sulfadiazine. This treatment allows comfort for the patient by reducing dressing changes and local pain intensity, beyond lower treatment costs.