{"title":"使用专用口服营养补充剂治疗糖尿病患者和非糖尿病患者的慢性伤口:成本效益分析","authors":"Adriano Antonio Mehl MD, MSc, PhD , Victoria Marzagão Ribeiro Pagliosa BSc , Débora Auad Tauil BSc , Valéria Abrahão Schilling Rosenfeld MD","doi":"10.1016/j.vhri.2024.101049","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>To analyze the cost-effectiveness of the use of a specialized oral nutritional supplement (ONS) with proline, arginine, vitamins, and micronutrients to stimulate the healing of chronic wounds in patients with and without diabetes mellitus.</div></div><div><h3>Methods</h3><div>This is a quantitative study on cost-effectiveness. This model used a decision-tree model followed by a budget impact analysis from the Brazilian public healthcare system’s perspective. For this analysis, the population and data from a randomized trial of an oral specialized-ONS-containing supplement were considered. For budget impact analysis, an epidemiologic approach was used to estimate the eligible population. The eligible population comprised 3 different groups: patients with pressure ulcers, patients with vascular ulcers, and patients with diabetic feet. The budget impact analysis used the results of the cost-effectiveness analysis.</div></div><div><h3>Results</h3><div>The results demonstrate that the use of specialized ONS, when compared with control ONS, proved to be cost saving (cheaper and more effective), considering the presence of predictive scar factor. The aggregated budget impact analysis results shows that the total reduction of costs after 5 years is USD 332 628 437.00.</div></div><div><h3>Conclusions</h3><div>The use of a specialized ONS was cost-effective in the healing of chronic wounds, when compared with control. The budget impact analysis showed a significant decrease in costs in a 5-year time horizon for the management of pressure ulcers, vascular ulcers, and diabetic feet.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Use of a Specialized Oral Nutritional Supplement in the Management of Chronic Wounds in Patients With and Without Diabetes Mellitus: Cost-Effectiveness Analysis\",\"authors\":\"Adriano Antonio Mehl MD, MSc, PhD , Victoria Marzagão Ribeiro Pagliosa BSc , Débora Auad Tauil BSc , Valéria Abrahão Schilling Rosenfeld MD\",\"doi\":\"10.1016/j.vhri.2024.101049\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><div>To analyze the cost-effectiveness of the use of a specialized oral nutritional supplement (ONS) with proline, arginine, vitamins, and micronutrients to stimulate the healing of chronic wounds in patients with and without diabetes mellitus.</div></div><div><h3>Methods</h3><div>This is a quantitative study on cost-effectiveness. This model used a decision-tree model followed by a budget impact analysis from the Brazilian public healthcare system’s perspective. For this analysis, the population and data from a randomized trial of an oral specialized-ONS-containing supplement were considered. For budget impact analysis, an epidemiologic approach was used to estimate the eligible population. The eligible population comprised 3 different groups: patients with pressure ulcers, patients with vascular ulcers, and patients with diabetic feet. The budget impact analysis used the results of the cost-effectiveness analysis.</div></div><div><h3>Results</h3><div>The results demonstrate that the use of specialized ONS, when compared with control ONS, proved to be cost saving (cheaper and more effective), considering the presence of predictive scar factor. The aggregated budget impact analysis results shows that the total reduction of costs after 5 years is USD 332 628 437.00.</div></div><div><h3>Conclusions</h3><div>The use of a specialized ONS was cost-effective in the healing of chronic wounds, when compared with control. The budget impact analysis showed a significant decrease in costs in a 5-year time horizon for the management of pressure ulcers, vascular ulcers, and diabetic feet.</div></div>\",\"PeriodicalId\":23497,\"journal\":{\"name\":\"Value in health regional issues\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2024-10-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Value in health regional issues\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2212109924000827\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Value in health regional issues","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2212109924000827","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
摘要
目的分析使用含脯氨酸、精氨酸、维生素和微量元素的专用口服营养补充剂(ONS)来促进糖尿病患者和非糖尿病患者慢性伤口愈合的成本效益:这是一项关于成本效益的定量研究。该模型采用决策树模型,然后从巴西公共医疗系统的角度进行预算影响分析。在分析过程中,考虑了人口和含特殊ONS口服补充剂随机试验的数据。在进行预算影响分析时,采用了流行病学方法来估算符合条件的人群。符合条件的人群包括 3 个不同的群体:压疮患者、血管性溃疡患者和糖尿病足患者。预算影响分析采用了成本效益分析的结果:结果表明,考虑到存在预测性疤痕因素,使用专用 ONS 与对照 ONS 相比,证明可以节省成本(更便宜、更有效)。综合预算影响分析结果显示,5 年后减少的总费用为 332 628 437.00 美元:与对照组相比,使用专门的 ONS 治疗慢性伤口具有成本效益。预算影响分析表明,在 5 年时间内,压疮、血管溃疡和糖尿病足的治疗成本大幅降低。
The Use of a Specialized Oral Nutritional Supplement in the Management of Chronic Wounds in Patients With and Without Diabetes Mellitus: Cost-Effectiveness Analysis
Objectives
To analyze the cost-effectiveness of the use of a specialized oral nutritional supplement (ONS) with proline, arginine, vitamins, and micronutrients to stimulate the healing of chronic wounds in patients with and without diabetes mellitus.
Methods
This is a quantitative study on cost-effectiveness. This model used a decision-tree model followed by a budget impact analysis from the Brazilian public healthcare system’s perspective. For this analysis, the population and data from a randomized trial of an oral specialized-ONS-containing supplement were considered. For budget impact analysis, an epidemiologic approach was used to estimate the eligible population. The eligible population comprised 3 different groups: patients with pressure ulcers, patients with vascular ulcers, and patients with diabetic feet. The budget impact analysis used the results of the cost-effectiveness analysis.
Results
The results demonstrate that the use of specialized ONS, when compared with control ONS, proved to be cost saving (cheaper and more effective), considering the presence of predictive scar factor. The aggregated budget impact analysis results shows that the total reduction of costs after 5 years is USD 332 628 437.00.
Conclusions
The use of a specialized ONS was cost-effective in the healing of chronic wounds, when compared with control. The budget impact analysis showed a significant decrease in costs in a 5-year time horizon for the management of pressure ulcers, vascular ulcers, and diabetic feet.