{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,15]],"date-time":"2023-10-15T00:30:47Z","timestamp":1697329847798},"reference-count":28,"publisher":"Mark Allen Group","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wound Care"],"published-print":{"date-parts":[[2009,5]]},"abstract":"Objective:<\/jats:title> To assess the cost-effectiveness of using amelogenin plus compression bandaging versus compression bandaging alone in treating non-healing venous leg ulcers (VLUs) of over six months' duration, from the perspective of the national health service in England. <\/jats:p><\/jats:sec>Method:<\/jats:title> A 12-month Markov model was constructed that depicted the management of a chronic, non-healing VLU of over six months' duration. The model considers the decision by a clinician to treat a recalcitrant VLU with amelogenin plus compression bandaging or compression bandaging alone, and was used to estimate the relative cost-effectiveness of amelogenin plus compression bandaging at 2006\u20132007 prices. <\/jats:p><\/jats:sec>Results:<\/jats:title> According to the model, 60% of all wounds treated with amelogenin plus compression bandaging are expected to heal within 12 months of the start of treatment compared with 41% of wounds treated with compression bandaging alone (p<0.01). Additionally, 23% of all amelogenin-treated wounds are expected to improve compared with 18% of wounds in the compression bandaging alone group. This difference in effectiveness between the two groups is expected to lead to a 7% improvement in health gain among amelogenin-treated patients when compared with those treated with compression bandaging alone (0.800 versus 0.746 QALYs; p<0.01) at 12 months after the start of treatment. Use of amelogenin is expected to lead a 10% reduction in NHS cost over 12 months from \u00a34,261 (95% CI: \u00a33,409; \u00a35,114) to \u00a33,816 (95% CI: \u00a33,227; \u00a34,405), due in part to a reduction in the requirement for nurse visits. Hence, amelogenin plus compression bandaging was found to be a dominant treatment. Moreover, use of amelogenin is expected to free-up NHS resources for alternative use within the system. <\/jats:p><\/jats:sec>Conclusion:<\/jats:title> Within the model's limitations, amelogenin plus compression bandaging is expected to afford the NHS a cost-effective dressing compared with compression bandaging alone in the management of chronic non-healing VLUs of more than six months' duration. <\/jats:p><\/jats:sec>Declaration of interest:<\/jats:title> This study was sponsored by M\u00f6lnlycke Heath Care. The authors have no other conflicts of interest that are directly relevant to the content of this manuscript. <\/jats:p><\/jats:sec>","DOI":"10.12968\/jowc.2009.18.5.42176","type":"journal-article","created":{"date-parts":[[2014,5,23]],"date-time":"2014-05-23T15:57:39Z","timestamp":1400860659000},"page":"216-224","source":"Crossref","is-referenced-by-count":13,"title":["Modelling the relative cost-effectiveness of amelogenin in non-healing venous leg ulcers"],"prefix":"10.12968","volume":"18","author":[{"given":"J.F.","family":"Guest","sequence":"first","affiliation":[{"name":"Catalyst Health Economics Consultants, Northwood, UK;"},{"name":"Postgraduate Medical School, Surrey University, Guildford, UK;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Nagy","sequence":"additional","affiliation":[{"name":"Catalyst Health Economics Consultants, Northwood, UK;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Sladkevicius","sequence":"additional","affiliation":[{"name":"Catalyst Health Economics Consultants, Northwood, UK;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Vowden","sequence":"additional","affiliation":[{"name":"Vascular Unit, Bradford Royal Infirmary, Bradford, UK;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Price","sequence":"additional","affiliation":[{"name":"Department of Wound Healing, School of Medicine, Cardiff University, Cardiff, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5130","reference":[{"key":"p_2","volume-title":"School of Medicine","author":"Department of Wound Healing"},{"key":"p_4","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2003.05222.x"},{"key":"p_11","unstructured":"Asystematic literature search was performed using the Medline, Embase, Cochrane and health technology databases for papers on VLUs to provide estimates on recurrence rates. The search strategy was not limited by year of publication, but only English language papers were included. The search terms were VLUs with and without one of the following: recurrence, relapse, treatment. A manual literature search was also undertaken, based on citations in the published papers. Only studies detailing the management of exuding (which was not defined) VLUs under compression were used to obtain recurrence rates up to 12 months after an ulcer had healed7-18(Fig 3)."},{"key":"p_12","unstructured":"Studies were excluded if patients had undergone surgery for their VLU. Studies published before 1990 were also excluded."},{"key":"p_15","unstructured":"\u25cf Model inputs: resource use Within the model, patients' use of resources (number of nurse visits, dressing changes and drug prescriptions) during the first 12 weeks of treatment are based on resource use in the trial. Additionally, resource use over weeks 9-12 in the trial was used to forecast resource use up to week 52 in the model. It was assumed that patients who discontinued the trial would continue using the same level of resources up to week 52 as that consumed during their last four weeks in the trial."},{"key":"p_23","doi-asserted-by":"publisher","DOI":"10.1111\/j.1067-1927.2004.012206.x"},{"key":"p_25","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16353-8"},{"key":"p_26","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2006.00117.x"},{"key":"p_28","doi-asserted-by":"publisher","DOI":"10.12968\/jowc.2007.16.5.27043"},{"key":"p_29","doi-asserted-by":"publisher","DOI":"10.12968\/jowc.2008.17.1.27916"},{"key":"p_30","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2002.121984"},{"key":"p_31","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/24.6.490"},{"key":"p_40","unstructured":"The model assumes that VLUs >0-10cm2would be treated with 0.5ml of amelogenin at \u00a356.00 per vial and VLUs >10-20cm2would be treated with 1ml of amelogenin at \u00a398.00 per vial."},{"key":"p_41","unstructured":"By assigning unit resource costs at 2006-2007 prices20-23to the resource utilisation estimates within the Markov model, the expected direct health-care cost over 12 months from the start of treatment was estimated. Fig 4. Expected probability of VLU healing over 12 months from the start of treatment 0.7 0.6 0.5 0.4 0.3 0.2 0.1"},{"key":"p_44","doi-asserted-by":"publisher","DOI":"10.1016\/S1078-5884(00)91196-1"},{"key":"p_46","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.316.7143.1487"},{"key":"p_47","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2004.10.002"},{"key":"p_48","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2006.05.039"},{"key":"p_54","doi-asserted-by":"publisher","DOI":"10.1185\/030079906X167705"},{"key":"p_55","unstructured":"Drug Tariff 2007. www. drugtariff.com"},{"key":"p_57","unstructured":"Department of Health NHS Reference Costs 2006. www.dh.gov.uk"},{"key":"p_66","volume-title":"Unit Costs of Health and Social Care","author":"Curtis L.","year":"2007"},{"key":"p_67","volume-title":"Personal Social Services Research Unit","author":"University of Kent","year":"2007"},{"key":"p_69","unstructured":"Nursing. The management of patients with venous leg ulcers. Recommendations for assessment, compression bandaging, cleansing, debridement, dressing, contact sensitivity, training\/ education and quality assurance. RCN, 1998."},{"key":"p_70","first-page":"58","volume":"3","author":"Rippon M.","year":"2007","journal-title":"Wounds UK"},{"key":"p_72","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-475X.2004.tb00001.x"},{"key":"p_75","doi-asserted-by":"publisher","DOI":"10.1016\/j.biomaterials.2005.12.026"},{"key":"p_76","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-051X.2003.00413.x"}],"container-title":["Journal of Wound Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.magonlinelibrary.com\/doi\/pdf\/10.12968\/jowc.2009.18.5.42176","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T00:51:24Z","timestamp":1653353484000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.magonlinelibrary.com\/doi\/10.12968\/jowc.2009.18.5.42176"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,5]]},"references-count":28,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2009,5]]}},"alternative-id":["10.12968\/jowc.2009.18.5.42176"],"URL":"https:\/\/doi.org\/10.12968\/jowc.2009.18.5.42176","relation":{},"ISSN":["0969-0700","2052-2916"],"issn-type":[{"value":"0969-0700","type":"print"},{"value":"2052-2916","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,5]]}}}