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