title: Cost-effectiveness of using Polyheal compared with surgery in the management of chronic wounds with exposed bones and/or tendons due to trauma in France, Germany and the UK.
abstract: The objective of this study was to assess the cost-effectiveness of Polyheal compared with surgery in treating chronic wounds with exposed bones and/or tendons (EB&T) due to trauma in France, Germany and the UK, from the perspective of the payers. Decision models were constructed depicting the management of chronic wounds with EB&T and spanned the period up to healing or up to 1 year. The models considered the decision by a plastic surgeon to treat these wounds with Polyheal or surgery and was used to estimate the relative cost-effectiveness of Polyheal at 2010/2011 prices. Using Polyheal instead of surgery is expected to increase the probability of healing from 0·93 to 0·98 and lead to a total health-care cost of €7984, €7517 and €8860 per patient in France, Germany and the UK, respectively. Management with surgery is expected to lead to a total health-care cost of €12 300, €18 137 and €11 330 per patient in France, Germany and the UK, respectively. Hence, initial treatment with Polyheal instead of surgery is expected to lead to a 5% improvement in the probability of healing and a substantial decrease in health-care costs of 35%, 59% and 22% in France, Germany and the UK, respectively. Within the models' limitations, Polyheal potentially affords the public health-care system in France, Germany and the UK a cost-effective treatment for chronic wounds with EB&T due to trauma, when compared with surgery. However, this will be dependent on Polyheal's healing rate in clinical practice when it becomes routinely available.
authors.affiliation: Catalyst Health Economics Consultants, Northwood, UK; School of Biomedical Sciences, King's College, London, UK.
authors.forename: Julian F
authors.initials: JF
authors.lastname: Guest
authors.forename: Erikas
authors.initials: E
authors.lastname: Sladkevicius
authors.forename: Monica
authors.initials: M
authors.lastname: Panca
mesh_terms: D001458:Bandages / Q000191:economics*; D002908:Chronic Disease; D003362:Cost-Benefit Analysis; D005060:Europe; D006801:Humans; D008863:Microspheres; D018803:Models, Economic; D011137:Polystyrenes; D019651:Plastic Surgery Procedures / Q000191:economics*; D014947:Wounds and Injuries / Q000191:economics / Q000473:pathology / Q000628:therapy*
chemical_list: D011137:Polystyrenes
keywords: Chronic wound; Cost-effectiveness; Flap; France; Germany; Polyheal; Skin graft; UK