COST EFFECTIVENESS OF ADDING CLOSTRIDIAL COLLAGENASE OINTMENT TO STANDARD OF CARE IN INDIVIDUALS WITH STAGE IV PRESSURE ULCERS
Author(s)
Carter M1, Gilligan A2, Waycaster CR3, Schaum K4
1Strategic Solutions Inc., Cody, WY, USA, 2Truvan Health Analytics, Ann Arbor, MI, USA, 3Smith & Nephew Inc., Fort Worth, TX, USA, 4Smith & Nephew Inc., Lake Worth, FL, USA
OBJECTIVES: To determine the cost-effectiveness of adding clostridial collagenase ointment (CCO) to standard of care (SOC) for stage IV pressure ulcers (PU) treated in the outpatient setting of care. METHODS: A 3-state Markov model with a cycle length of 4 weeks was chosen to estimate the costs and clinical consequences of the adjunctive use of CCO. The time horizon for the economic analysis was 2-years. The Markov PU health states were unhealed, healed, and dead. Healing rates used in the economic analysis were derived from an examination of stage IV PU closure rates observed in the US Wound Registry (USWR). The clinical analysis of USWR data revealed that the proportion of stage IV PU closed at 1 year and 2 years was double for PU treated with CCO compared to those treated with SOC. Mortality rates were modeled using the age structure of the two comparative cohorts using national census data. Unit costs included outpatient visits at hospital-based wound care clinics, dressing changes, debridement, and offloading. Costs were based on 2015 Medicare reimbursement rates with the exception of commercial costs for supplementary offloading devices. Costs and effectiveness were discounted at 3% for the second year. The model was calibrated in stages using a dependent validity method to ensure that final results were within prescribed limits when compared against USWR parameters. A sensitivity analysis was performed to assess model uncertainty. RESULTS: The base-case cost-effectiveness analysis revealed that the use of CCO saved an estimated $6,445 per patient and added an additional 17.2 ulcer-free weeks over the 2-year period. Sensitivity analyses showed that results remained robust within the values tested. CONCLUSIONS: The addition of CCO to SOC in outpatients with stage IV pressure ulcers results in both cost savings and improved clinical benefits.
Conference/Value in Health Info
2016-05, ISPOR 2016, Washington DC, USA
Value in Health, Vol. 19, No. 3 (May 2016)
Code
CE2
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Sensory System Disorders