Waycaster C, Milne C, et al.
Wounds : a compendium of clinical research and practice. Date of publication 2013 Jun 1;volume 25(6):141-7.
1. Wounds. 2013 Jun;25(6):141-7.
Economic and clinical benefit of collagenase ointment compared to a hydrogel
dressing for pressure ulcer debridement in a long-term care setting.
Waycaster C(1), Milne C(2).
Author information:
(1)Healthpoint Biotherapeutics, Fort Worth, TX; email:
Curtis.Waycaster@Healthpoint.com.
(2)Connecticut Clinical Nursing Associates, LLC, Bristol, CT.
INTRODUCTION: The purpose of this study is to determine the cost-effectiveness of
collagenase ointment relative to autolysis with a hydrogel dressing when
debriding necrotic pressure ulcers in a long-term care setting.
METHODS: A Markov decision process model with 2 states (necrotic nonviable wound
bed transitioning to a granulated viable wound bed) was developed using data
derived from a prospective, randomized, 6-week, single-center trial of 27
institutionalized subjects with pressure ulcers that were ≥ 85% necrotic
nonviable tissue. Direct medical costs from the payer perspective included study
treatments, wound treatment supplies, and nursing time. Clinical benefit was
measured as "granulation days" and was derived from the time-dependent
debridement rates of the alternative products.
RESULTS: The average cost per patient for 42 days of pressure ulcer care was
$1,817 in 2012 for the collagenase group and $1,611 for the hydrogel group. Days
spent with a granulated wound were 3.6 times higher for collagenase (23.4 vs 6.5)
than with the hydrogel. The estimated cost per granulation day was > 3.2 times
higher for hydrogel ($249) vs collagenase ($78).
CONCLUSIONS: In this economic analysis based on a randomized, controlled clinical
trial, collagenase ointment resulted in a faster time to complete debridement and
was more cost-effective than hydrogel autolysis for pressure ulcers in a
long-term care setting. Even though collagenase ointment has a higher acquisition
cost than hydrogel, the clinical benefit offsets the initial cost difference,
resulting in lower cost per granulation day to the nursing home over the course
of the 42-day analysis.
PMID: 25866979
