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Comparing Costs of Wound Therapy in the Post-Acute Setting

Article originally featured on AJMC.com

Wound care is costly, costing at least $28.1 billion annually for the Medicare population alone. Treating patients with wounds can be complex as they often have multiple comorbidities that impede wound healing. A comparative effectiveness analysis published in Cureus analyzed differences in cost and effectiveness of negative pressure wound therapy (NPWT) suppliers. “Typically, providers prescribe NPWT for the most challenging wounds when granulation tissue formation cannot be achieved via other methods or when other wound care methods have been tried or considered and ruled out,” the authors explained. They conducted a retrospective analysis using a large, longitudinal, closed system deidentified patient-level database. Patients included in the study had 1 or more outpatient diagnosis claims with an NPWT Healthcare Common Procedure Code between July 2015 and September 2019. Patients were separated into 2 groups: those who had V.A.C. Therapy from KCI, now part of 3M Company (NPWT-K) and those who had other non-KCI models (NPWT-O). A total of 15,180 patients were included, 11,812 in the NPWT-K group and 3368 in the NPWT-O group. NPWT-K patients were case-matched to NPWT-O patients for a cohort of 3368 patients in each group. In the case-matched group, the mean age was 67 years, 50.5% were male, and the mean Charlson comorbidity score was 3.4. The top comorbidities were hypertension (54.2% for NPWT-K and 52.7% for NPWT-O), type 2 diabetes without complications (28.9% and 29.2%), hyperlipidemia (22.0% and 22.9%), atherosclerotic heart disease of native coronary artery (17.0% and 16.6%), and peripheral vascular disease (12.8% and 12.9%). Four types of wounds represented 75% of all wounds:

  • Open wounds: 25.1% for NPWT-K and 24.7% for NPWT-O

  • Non-healing surgical wounds: 21.3% for NPWT-K and 15.6% for NPWT-O

  • Diabetic ulcers: 19.0% for NPWT-K and 18.7% for NPWT-O

  • Pressure ulcers: 9.5% for NPWT-K and 13.5% for NPWT-O

“Within the study population, wound-related and total cost to treat were significantly higher for the NPWT-O group across all time periods,” the authors found. For 30 days, the wound-related cost was $8583 in the NPWT-K group vs $11,334 in the NPWT-O group (P < .0001), and for 12 months the cost was $35,625 vs $48,640 (P < .0001). For 30 days, the total cost to treat was $17,809 in the NPWT-K group vs $24,405 in the NPWT-O group (P < .0001), and for 12 months the cost was $105,844 vs $137,928 (P < .0001). In the short term, pressure ulcers had the highest wound-related cost for the NPWT-K group ($12,343) while diabetic foot ulcers cost the most had the highest total cost to treat ($20,593). Non-healing surgical wounds cost the least, at $3650 for wound-related costs and $13,767 for total cost to treat. The highest costs in the short term for the NPWT-O group was diabetic foot ulcers ($16,102 for wound-related treatment and $28,750 for total cost to treat). Non-healing surgical wounds were the least expensive at $6931 for wound-related costs and $20,752 for total cost to treat. “While costs for therapy use is a significant component of healthcare costs, reimbursement payment methodologies to reflect the support and service levels complex wound patients require may be equally important in reducing healthcare expenditures,” the authors concluded.

Reference Law AL, Krebs B, Karnik B, Griffin L. Comparison of healthcare costs associated with patients receiving traditional negative pressure wound therapies in the post-acute setting. Cureus. 2020;12(11):e11790. doi:10.7759/cureus.11790