Gilligan AM, Waycaster CR, Milne CT, et al.
Wounds : a compendium of clinical research and practice. Date of publication 2018 Jun 1;volume 30(6):197-204.
1. Wounds. 2018 Jun;30(6):197-204. Epub 2018 Mar 21.
Cost Effectiveness of Becaplermin Gel on Wound Closure for the Treatment of
Pressure Injuries.
Gilligan AM, Waycaster CR, Milne CT.
OBJECTIVE: This study aims to determine the cost effectiveness of becaplermin gel
on wound healing for the treatment of stage 3 and stage 4 pressure injuries
(PIs).
MATERIALS AND METHODS: A 2-stage Markov model was used to predict expected costs
and outcomes of wound healing for becaplermin gel once daily plus good wound care
(BGWC) compared with a placebo gel plus good wound care (control) over 1 year;
good wound care consisted of debridement, infection management, and moisture
balance. Patients in both arms received dressing changes and gel applications
twice daily. Outcome data used in the analysis were derived from a 16-week
randomized clinical trial. The primary outcome of interest was PI-free weeks.
Transition probabilities for the Markov states were estimated from the clinical
trial. Pressure injury recurrence rates were derived from PI literature.
Utilization for becaplermin was calculated using the manufacturer's recommended
dosing algorithm. Costs were derived from standard cost references and medical
supply wholesalers; economic perspective taken was that of the long-term care
facility.
RESULTS: A total of 62 patients completed the study: 31 for BGWC and 31 for
control. Over 1 year, patients treated with BGWC had substantially higher PI-free
weeks compared with control patients (11.6 vs. 3.1, respectively). Patients
treated with BGWC incurred higher total costs than those receiving the control
treatment. Expected annual direct costs for PI were $3827 for BGWC and $1279 for
the control. The incremental cost-effectiveness ratio was $298 (about $43/day),
indicating that patients would have to pay an extra $298 to gain 1 additional
PI-free week.
CONCLUSIONS: Becaplermin gel plus good wound care was cost effective over
standard of care, yielding better outcomes at a slightly higher cost and should
be considered for management of PIs.
PMID: 29809161 [Indexed for MEDLINE]
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