Journal of medical economics · 2026
Management of moderate-to-highly exuding leg ulcers with polyacrylate superabsorbent wound dressings versus foam dressings in spanish settings: an early-stage cost-effectiveness and budget-impact analysis.
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Veličković Vladica, Torra I Bou Joan-Enric, Cegri Francisco, Llatas Federico Palomar
Аннотация
AIM: This study evaluates the incremental cost‑effectiveness and budget impact of polyacrylate Superabsorbent (SAP) dressings compared with foam dressings for the management of moderate‑to‑highly exuding leg ulcers in the Spanish healthcare setting.
METHODS: We developed a weekly-cycle microsimulation state-transition model over 24 weeks from the Spanish National Health System perspective. Clinical effectiveness inputs for SAP dressings were derived from IPD from two observational clinical studies (n = 84, 2-week follow-up). Foam-dressing effectiveness was informed by a systematic review and meta-analysis of three eligible studies reporting 14-day wound-area reduction. The modelled cohort represented patients with moderate-to-highly exuding leg ulcers managed with compression therapy as standard of care; baseline severity was parameterised from the IPD (mean ulcer duration 15.1 months; baseline wound size 5,765 mm2).
RESULTS: This early-stage model predicts an absolute incremental improvement in healing rate of 2.41 percentage points, an absolute incremental gain of 0.135 quality‑adjusted life weeks (QALWs) over a 24‑week period, and an absolute per‑patient direct cost reduction of €729 when SAP dressings are compared with foam dressings. When these incremental results are extrapolated to a hypothetical scenario of 100% adoption, the Spanish National Health System could achieve annual cost savings of €55.557 million. These estimates should be interpreted cautiously given the early‑stage, non‑comparative nature of the underlying evidence.
LIMITATIONS: Treatment‑effect estimates were derived from non‑randomized studies, which may introduce unmeasured confounding. As a result, the magnitude of the incremental effects is uncertain. To evaluate robustness, we conducted deterministic and probabilistic sensitivity analyses, both of which showed that the direction of the base‑case findings remained consistent across all plausible parameter ranges.
CONCLUSIONS: Preliminary model predictions suggest that polyacrylate wound dressings may provide additional health benefits and potentially reduce costs compared with foam dressings within the Spanish Health Care System.
METHODS: We developed a weekly-cycle microsimulation state-transition model over 24 weeks from the Spanish National Health System perspective. Clinical effectiveness inputs for SAP dressings were derived from IPD from two observational clinical studies (n = 84, 2-week follow-up). Foam-dressing effectiveness was informed by a systematic review and meta-analysis of three eligible studies reporting 14-day wound-area reduction. The modelled cohort represented patients with moderate-to-highly exuding leg ulcers managed with compression therapy as standard of care; baseline severity was parameterised from the IPD (mean ulcer duration 15.1 months; baseline wound size 5,765 mm2).
RESULTS: This early-stage model predicts an absolute incremental improvement in healing rate of 2.41 percentage points, an absolute incremental gain of 0.135 quality‑adjusted life weeks (QALWs) over a 24‑week period, and an absolute per‑patient direct cost reduction of €729 when SAP dressings are compared with foam dressings. When these incremental results are extrapolated to a hypothetical scenario of 100% adoption, the Spanish National Health System could achieve annual cost savings of €55.557 million. These estimates should be interpreted cautiously given the early‑stage, non‑comparative nature of the underlying evidence.
LIMITATIONS: Treatment‑effect estimates were derived from non‑randomized studies, which may introduce unmeasured confounding. As a result, the magnitude of the incremental effects is uncertain. To evaluate robustness, we conducted deterministic and probabilistic sensitivity analyses, both of which showed that the direction of the base‑case findings remained consistent across all plausible parameter ranges.
CONCLUSIONS: Preliminary model predictions suggest that polyacrylate wound dressings may provide additional health benefits and potentially reduce costs compared with foam dressings within the Spanish Health Care System.