Budget impact of antimicrobial wound dressings in the treatment of venous leg ulcers in the German outpatient care sector: a budget impact analysis

Headnote

ABSTRACT

Background: Hard-to-heal wounds are associated with high treatment costs and, in Germany, are mostly treated in the outpatient care sector. Wound dressings are the main cost-drivers in venous leg ulcer (VLU) care which prescription is budget-restricted.

Objective: To determine to what extent the choice of antimicrobial dressing affects the spending in outpatient care by investigating the budget impact of the bioburden-reducing dressing Cutimed Sorbact.

Methods: The budget impact analysis was performed comparing three different scenarios of the intervention mix of antimicrobial dressings. A Markov model was used to estimate the VLU progression during one year. The budget impact was determined by comparing the dressing and medicine resource use and costs of the three scenarios.

Results: This analysis confirms the high treatment costs of VLU care. ScenarioA leads to a decreased resource use of antimicrobial dressings and results in 20.86% lower treatment costs after 12 months. The increased use of Cutimed Sorbact has a positive budget impact.

Conclusion: This analysis indicates that the treatment of VLU patients may result in an exceedance of the budget per patient that is available to the treating practitioner. The choice of wound dressing, however, may positively affect the prescribers' budget spending in outpatient care.

ARTICLE HISTORY

Received 7 June 2018 Revised 8 September 2018 Accepted 14 September 2018

KEYWORDS

Budget impact; cost-ofillness; Health economics; outpatient care; venous leg ulcer; chronic wounds; antimicrobial wound dressings; Cutimed Sorbact; DACC; silver dressings

Introduction

Due to the aging population, the prevalence and incidence of hard-to-heal wounds is predicted to increase. Such wounds impact the quality of life of affected patients and their families, impose an increased burden on their daily lives and mean significant costs to the society. It is therefore important to focus on high quality therapy standards to ensure best practice [1,2].

Venous leg ulcers (VLUs) have the highest prevalence of hard-to-heal wounds [3]. About 0.6-1% of the German population are diagnosed with a VLU, with the prevalence in people above the age of 60 being higher (3.9%) [4]. Only about half ofVLUs heal within 4 months, and healed ulcers show high recurrence rates of 30 to 57% within the first year after wound closure [5].

Standard of Care (S°C) for the treatment of VLUs is compression therapy [5]. In...