PMD103 - COST-EFFECTIVENESS AND COST-UTILITY ANALYSIS OF TREATING LEG ULCERS WITH URGOSTART COMPARED TO A NEUTRAL DRESSING.

Abstract

Leg Ulcers (LUs) cause a burden on the patient and National Health Service (NHS); often taking a long time to heal and requiring significant resources to achieve wound closure. UrgoStart has been demonstrated to improve healing outcomes for patients with LUs. This study examined the cost-effectiveness of UrgoStart compared with a neutral dressing for LU patients. A Markov-model with four health states: open, infected, closed and deceased. Infected wounds had to become open wounds in order to close, and closed wounds had a risk of recurrence. The model took the perspective of the NHS in the United Kingdom, with a cohort of 1000 patients and base-case time horizon of 1 year. The Challenge randomised double blind controlled trial informed the patient characteristics and transitions. The study endpoint was relative wound area reduction at 8 weeks; which was used to calculate the transition probability of healing in the model. Both deterministic and probabilistic sensitivity analyses were performed. UrgoStart was the dominant treatment strategy in terms of cost-effectiveness, with a cost saving of £274.25 and a 0.03 gain in quality-adjusted-life years, per patient. Community nurse visits were the primary cost driver; accounting for 54% and 56% of total costs in the treatment and comparator arm respectively. At 52 weeks 949 wounds had healed using UrgoStart vs 854 wounds using a neutral dressing, at a cost of £1666.80 and £2174.89 per healed wound respectively. Sensitivity analysis showed a cost saving for UrgoStart, even when a comparator was set at £0 cost; over 1000 runs of the model, UrgoStart was dominant in approximately 90% of cases. This analysis showed UrgoStart to be a cost-effective treatment option for treating LU; with benefits for the patient and the NHS. UrgoStart should be considered as a treatment for patients with a LU.