Cost-effectiveness of Debrichem in managing hard-to-heal venous leg ulcers in the UK

Abstract

Objective: To estimate whether the topical debriding agent, Debrichem, could potentially afford the UK’s National Health Service (NHS) a cost-effective intervention for the management of hard-to-heal venous leg ulcers (VLUs).

Method: A Markov model was constructed depicting the management of hard-to-heal VLUs with Debrichem plus standard care (SC) or SC alone over a period of 12 months. The model was populated with inputs from an indirect comparison of two propensity score-matched cohorts. The model estimated the cost-effectiveness of the two interventions in terms of the incremental cost per quality-adjusted life year (QALY) gained at 2019/20 prices.

Results: Addition of Debrichem to a SC protocol to treat hard-to- heal VLUs was found to increase the probability of healing by 75% (from 0.35 to 0.61) by 12 months, and to increase health-related quality of life over 12 months from 0.74 to 0.84 QALYs per patient. The 12-month cost of treatment with Debrichem plus SC (£3 128 per patient) instead of SC alone (£7 195 per patient) has the potential to reduce the total NHS cost of wound management by up to 57%. Hence, Debrichem was estimated to improve health outcomes for less cost. Sensitivity analysis showed that Debriche plus SC remained a cost-effective (dominant) treatment with plausible variations in costs and effectiveness.

Conclusion: Within the limitations of the study, the addition of Debrichem to a SC protocol potentially affords a cost-effective treatment to the NHS for managing hard-to-heal VLUs.

Declaration of interest: This study was commissioned and funded by Edge Medical, Manchester, UK. The study’s sponsors had no involvement in the study design, analysis and interpretation of the data, and the writing of this manuscript. The views expressed in this article are those of the authors and not necessarily those of the sponsors. The authors have no other conflicts of interest to declare.