Mohammad KA Basra; Muhammad Shahrukh

Disclosures

Expert Rev Pharmacoeconomics Outcomes Res. 2009;9(3):271-283. 

In This Article

Leg Ulcers

Leg ulceration is relatively common; the prevalence for one leg ulcer is approx 1.8 per 1000[111] and 3.0 per 1000 for both leg and foot ulcers.[112] Overall, 60% of ulcers may exist for a period of 6 months or longer and approximately 33% can persist for over 1 year.[113] The chronic nature of this condition, the resulting restriction on the patient's mobility and the cost of medical care result in an immense socioeconomic impact of leg ulcers. In a population-based Australian study, as many as 45% of patients were found to be housebound due to the immobility resulting from chronic leg ulcers.[114] Studies have further shown that patients are socially withdrawn, have limitations on their leisure activities and experience significant problems at work.[115,116,117] In addition, leg ulcers can have a huge economic impact in the form of cost of management, which depends on a number of factors such as the type of the ulcer, severity, size and duration, underlying vascular status and associated complications (e.g., deep infections, osteomyelitis and amputation), as well on the local healthcare practices and protocols. In the UK, venous leg ulceration alone has been estimated to cost the National Health Service £400 million per year.[118,119] Much of this cost is accounted for by community nursing services and it is estimated that district nurses spend up to half of their time caring for patients with ulcers.[120,121] In a comparative study, the average cost of treating an ulcer was found to range between €814 and €1994 in the UK, while it ranged between €1332 and €2585 in Sweden.[122] The same study also discovered that the cost was highest for large-sized ulcers (> 10 cm2) and those of longer duration (> 6 months).[122] Similarly, the cost of treating a venous ulcer ($US1873-15,053) has been shown to be higher as compared with the cost of treating a pressure ulcer ($US910-2179).[123]

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