Budget impact of antimicrobial wound dressings in the treatment of venous leg ulcers in the German outpatient care sector: a budget impact analysis

ABSTRACT

Background: Hard-to-heal wounds are associated with high treatment costs and, in Germany, are mostly treated in the outpatient care sector. Wound dressings are the main cost-drivers in venous leg ulcer (VLU) care which prescription is budget-restricted.

Objective: To determine to what extent the choice of antimicrobial dressing affects the spending in outpatient care by investigating the budget impact of the bioburden-reducing dressing Cutimed Sorbact.

Methods: The budget impact analysis was performed comparing three different scenarios of the intervention mix of antimicrobial dressings. A Markov model was used to estimate the VLU progression during one year. The budget impact was determined by comparing the dressing and medicine resource use and costs of the three scenarios.

Results: This analysis confirms the high treatment costs of VLU care. Scenario_A leads to a decreased resource use of antimicrobial dressings and results in 20.86% lower treatment costs after 12 months. The increased use of Cutimed Sorbact has a positive budget impact.

Conclusion: This analysis indicates that the treatment of VLU patients may result in an exceedance of the budget per patient that is available to the treating practitioner. The choice of wound dressing, however, may positively affect the prescribers’ budget spending in outpatient care.

KEYWORDS:

• Budget impact
• cost-of-illness
• Health economics
• outpatient care
• venous leg ulcer
• chronic wounds
• antimicrobial wound dressings
• Cutimed Sorbact
• DACC
• silver dressings

Acknowledgments

We would like to acknowledge Dr. Karl-Christian Muenter and Jan Heggemann for their contribution as wound care specialists.

Disclosure statement

In accordance with Taylor & Francis policy and my ethical obligation as a researcher, I am reporting that I am an employee of the funder or this article, a company that may be affected by the research reported in the enclosed paper. I have disclosed those interests fully to Taylor & Francis, and I have in place an approved plan for managing any potential conflicts arising from that involvement.

Notes

¹ In the outpatient care sector, wound dressings that are defined as ‘Verbandmittel’ according to the German Federal Joint Committee (‘Gemeinsamer Bundesausschuss’) [33] are covered by the statutory health insurance (SHI). Since the budget per patient is fixed, the decision on which dressing to use for the treatment of a VLU is decided by the SHI-accredited practitioner according to the wound status (e.g. exudate level), the efficiency and medical necessity of the wound dressing [5,24].

² Further assumptions are presented in Appendix 2.

Additional information

Funding

This work was supported by BSN medical GmbH.