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Comparative Study
. 2017 Aug;14(4):616-628.
doi: 10.1111/iwj.12653. Epub 2016 Aug 4.

A cost-effectiveness analysis of optimal care for diabetic foot ulcers in Australia

Qinglu Cheng  1 , Peter A Lazzarini  2   3 , Michelle Gibb  4 , Patrick H Derhy  5 , Ewan M Kinnear  6 , Edward Burn  1 , Nicholas Graves  1 , Rosana E Norman  1   4
Affiliations
Comparative Study

A cost-effectiveness analysis of optimal care for diabetic foot ulcers in Australia

Qinglu Cheng et al. Int Wound J. 2017 Aug.

Abstract

In addition to affecting quality of life, diabetic foot ulcers (DFUs) impose an economic burden on both patients and the health system. This study developed a Markov model to analyse the cost-effectiveness of implementing optimal care in comparison with the continuation of usual care for diabetic patients at high risk of DFUs in the Australian setting. The model results demonstrated overall 5-year cost savings (AUD 9100·11 for those aged 35-54, $9391·60 for those aged 55-74 and $12 394·97 for those aged 75 or older) and improved health benefits measured in quality-adjusted life years (QALYs) (0·13 QALYs, 0·13 QALYs and 0·16 QALYs, respectively) for high-risk patients receiving optimal care for DFUs compared with usual care. Total cost savings for Australia were estimated at AUD 2·7 billion over 5 years. Probabilistic sensitivity analysis showed that optimal care always had a higher probability of costing less and generating more health benefits. This study provides important evidence to inform Australian policy decisions on the efficient use of health resources and supports the implementation of evidence-based optimal care in Australia. Furthermore, this information is of great importance for comparable developed countries that could reap similar benefits from investing in these well-known evidence-based strategies.

Keywords: Cost-effectiveness; Diabetic foot ulcer; Evidence-based practice; Markov model; Wound management.

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Figures

Figure 1
Figure 1
Markov model of diabetic foot ulcer. States are identical for usual and optimal care.
Figure 2
Figure 2
Cost‐effectiveness plane for optimal care over usual care (age 35–54; WTP, willingness‐to‐pay).
Figure 3
Figure 3
Cost‐effectiveness acceptability curve of optimal care and usual care (age 35–54; CE cost‐effectiveness).
Figure A1
Figure A1
Cost‐effectiveness plane for optimal care over usual care (age 55–74; WTP, willingness‐to‐pay).
Figure A2
Figure A2
Cost‐effectiveness plane for optimal care over usual care (age 75+; WTP, willingness‐to‐pay).
Figure A3
Figure A3
Cost‐effectiveness acceptability curve of optimal care and usual care (age 55–74; CE cost‐effectiveness).
Figure A4
Figure A4
Cost‐effectiveness acceptability curve of optimal care and usual care (age 75+; CE cost‐effectiveness).
See this image and copyright information in PMC

References

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