Economic model to examine the cost-effectiveness of FlowOx home therapy compared to standard care in patients with peripheral artery disease

Ezeofor, V‘S ORCID: https://orcid.org/0000-0002-4211-8942, Bray, N, Bryning, L, Hashmi, F ORCID: https://orcid.org/0000-0002-6257-2165, Hoel, H ORCID: https://orcid.org/0000-0003-1891-1614, Parker, DJ ORCID: https://orcid.org/0000-0001-9952-1225 and Tudor Edwards, R 2021, 'Economic model to examine the cost-effectiveness of FlowOx home therapy compared to standard care in patients with peripheral artery disease' , PLOS ONE, 16 (1) , e0244851.

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Abstract

Background: Critical limb ischaemia is a severe stage of lower limb peripheral artery disease which can lead to tissue loss, gangrene, amputation and death. FlowOx™ therapy is a novel negative-pressure chamber system intended for home use to increase blood flow, reduce pain and improve wound healing for patients with peripheral artery disease and critical limb ischaemia. Methods: A Markov model was constructed to assess the relative cost-effectiveness of FlowOx™ therapy compared to standard care in lower limb peripheral artery disease patients with intermittent claudication or critical limb ischaemia. The model used data from two European trials of FlowOx™ therapy and published evidence on disease progression. From an NHS analysis perspective, various FlowOx™ therapy scenarios were modelled by adjusting the dose of FlowOx™ therapy and the amount of other care received alongside FlowOx™ therapy, in comparison to standard care. Results: In the base case analysis, consisting of FlowOx™ therapy plus nominal care, the cost estimates were £12,704 for a single dose of FlowOx™ therapy per annum as compared with £15,523 for standard care. FlowOx™ therapy patients gained 0.27 additional quality adjusted life years compared to standard care patients. This equated to a dominant incremental cost-effectiveness ratio per QALY gained. At the NICE threshold WTP of £20,000 and £30,000 per QALY gained, FlowOx™ therapy in addition to standard care had a 0.80 and 1.00 probability of being cost-effectiveness respectively. Conclusions: FlowOx™ therapy delivered as a single annual dose may be a cost-effective treatment for peripheral artery disease. FlowOx™ therapy improved health outcomes and reduced treatment costs in this modelled cohort. The effectiveness and cost-effectiveness of FlowOx™ therapy is susceptible to disease severity, adherence, dose and treatment cost. Research assessing the impact of FlowOx™ therapy on NHS resource use is needed in order to provide a definitive economic evaluation.

Item Type: Article
Contributors: Serra, R (Editor)
Additional Information: ** From PLOS via Jisc Publications Router ** Licence for this article: http://creativecommons.org/licenses/by/4.0/ **Journal IDs: eissn 1932-6203 **Article IDs: publisher-id: pone-d-20-16557 **History: published_online 14-01-2021; collection 2021; accepted 17-12-2020; submitted 01-06-2020
Schools: Schools > School of Health and Society
Journal or Publication Title: PLOS ONE
Publisher: Public Library of Science
ISSN: 1932-6203
Related URLs:
Funders: European Commission Horizon 2020, Otivio AS via Norwegian Research Council grant
SWORD Depositor: Publications Router
Depositing User: Publications Router
Date Deposited: 15 Jan 2021 11:05
Last Modified: 15 Jan 2021 11:15
URI: http://usir.salford.ac.uk/id/eprint/59361

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