Estimated Economic Cost of Negative Pressure Wound Therapy with Instillation Versus Control Therapies

Abstract

Introduction

Healthcare systems are under immense pressure to deliver improved patient outcomes within ever-tightening budget constraints. Thus, economic analyses play an increasingly critical role in wound care product decision making. There is a dearth of large, prospective studies regarding the economic value of negative pressure wound therapy (NPWT) with instillation and dwelling of a topical wound solution (NPWTi-d*) versus other wound management strategies.

Methods

To address this gap, an economic model was developed to estimate cost of NPWTi-d versus control therapies, based on mean number of debridements during therapy, time to readiness for final surgical procedure, length of hospital stay, and length of therapy. Inputs were non-standardized means derived from results of a recently published systematic review/meta-analysis of 13 comparative NPWTi-d studies comprising 720 patients.1 Means across the analyzed studies (comprising complex acute and chronic wounds) for NPWTi-d versus Control (standard NPWT, gauze, or gentamicin polymethylmethacrylate beads) were 1.77 vs 2.69 surgical debridements (p=0.008), 7.88 vs 14.36 days to final surgical procedure (p=0.003), 11.39 vs 26.79 hospital stay days (p=0.02) and 9.88 vs 21.80 therapy days (p=0.02).

Results

Utilizing these inputs and an assumed mean daily cost of $2,517 per inpatient stay2 and $3,393 per operating room debridement,3 the economic model showed the following comparative costs for NPWTi-d vs Control, respectively: $28,669 vs $67,430 per inpatient stay, $6,006 vs $9,127 for debridement expenditures, and $1,415 vs $2,070 for NPWTi-d product versus standard NPWT product costs. Total estimated cost per patient for NPWTi-d vs Control, respectively, was $36,089 vs $78,628 based on assumed reduced length of hospital stay, fewer debridements, shorter length of therapy, and reduced time to final surgical procedure for NPWTi-d patients.

Conclusion

These economic model results, based on previous meta-analysis outcomes, show potential cost savings with use of NPWTi-d versus control therapies in managing complex chronic and acute wounds.

*V.A.C. VERAFLO™ Therapy, 3M Company, San Antonio, TX

References:

  1. Gabriel A, Camardo M, O'Rorke E, Gold R, Kim PJ. Effects of Negative Pressure Wound Therapy with Instillation Versus Standard of Care in Multiple Wound Types: Systematic Literature Review and Meta-Analysis. Plast Reconstr Surg. 2021;147(1S-1):68S-76S.
  2. Hospital Adjusted Expenses per Inpatient Day. Kaiser Family Foundation. https://www.kff.org/health-costs/state-indicator/expenses-per-inpatient-.... Source: American Hospital Association Survey 2018. Accessed December 11, 2020.
  3. Granick MS, Jacoby M, Noruthrun S, Datiashvili RO, Ganchi PA. Clinical and Economic Impact of Hydrosurgical Debridement on Chronic Wounds. Wounds 2006;18(2):35-39.

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