OBJECTIVES:

Complex wounds present a substantial economic burden on healthcare systems, costing billions of dollars in Europe and the US. The prevalence of complex wounds is a significant patient and societal healthcare concern and cost-effective wound-care management remains unclear. The model compares the following strategies for the wound-types venous, diabetic, arterial and mixed: PluroGel vs. Silver-dressing, Hydrogel-dressing, Medical-honey, Impregnated-dressings and Good-wound-care (GWC). All reimbursed products, corresponding to the reimbursement rule, were considered.

METHODS:

Markov-modeling techniques were used to estimate wound healing (=wound closure) according to wound types. The three Markov states included unhealed, healed and death. The model considers treatment changes and relapse. According to treatment specific healing-rates patients may move weekly from the health state “Unhealed” to the “Healed” state. This research utilized the outcomes data of a published 1,036 patient, 10-center clinical-study. A 1-year time horizon was used to determine the number of ulcer-free-weeks and the expected costs of therapies. Healing-rates were derived from a systematic literature review from the medical literature for all wound types and comparators. Cost data represent direct medical costs (2017€) for Austria. The payer’s perspective was adopted and only direct costs of care were considered. Sensitivity analyses were performed to gauge model parameter uncertainty.

RESULTS:

In all wound types PluroGel is associated with the lowest costs. In venous wounds PluroGel costs amount to 3,771€ (silver-dressings: 4,644€; hydrogel-dressings: 4,538€; medical-honey: 4,676€; impregnated-dressings: 4,324€; GWC: 6,764€). With PluroGel, patients reach the median healing-rate after 17 weeks. All comparators need prolonged healing-time (silver-dressings: 21 weeks; hydrogel-dressings: 21 weeks; medical-honey: 19 weeks; impregnated-dressings: 21 weeks; GWC: 22 weeks). Ulcer-free-weeks of PluroGel account for 31 weeks. All treatment alternatives show significantly fewer ulcer-free weeks (24.5 to 27.5 weeks).

CONCLUSIONS:

From the Austrian health-care-systems perspective PluroGel is the most cost-effective wound care product and yield potential cost-savings.