title: Comparative cost-effectiveness of four-layer bandaging in the treatment of venous leg ulceration.
abstract: This paper reports the results of an analysis designed to estimate the expected annual cost per patient of treating venous leg ulcers, and to evaluate the relative cost-effectiveness of a systematic treatment regimen using a four-layer compression bandaging system (Profore) compared with usual care. A Markov model has been developed which simulates the transition of patients between health states (healed and unhealed) over a 52-week period. Healing rates used in the model are derived from those reported in the literature. By running the model for a cohort of 100 patients over 52 weeks it is possible to estimate expected outcomes and annual budgetary costs for alternative treatment regimens. Results suggest that, when compared with usual care, a systematic treatment regimen using Profore is unambiguously more cost-effective. Patient outcomes are improved and annual treatment costs reduced. An important implication is that failure to co-ordinate treatment policies and to use the most cost-effective treatments may result in substantial inefficiency in the use of NHS resources. This inefficiency could represent the equivalent of between 350,000 Pounds and 1.08 million Pounds annually for a typical health authority.
authors.affiliation: York Health Economics Consortium, University of York, UK.
authors.forename: L
authors.initials: L
authors.lastname: Carr
authors.forename: Z
authors.initials: Z
authors.lastname: Philips
authors.forename: J
authors.initials: J
authors.lastname: Posnett
mesh_terms: D001458:Bandages / Q000191:economics*; D003362:Cost-Benefit Analysis; D006801:Humans; D007871:Leg Ulcer / Q000191:economics* / Q000628:therapy*; D017059:Models, Econometric; D016896:Treatment Outcome