Cost-Utility Analysis of Negative Pressure Wound Therapy Compared With Traditional Wound Care in the Treatment of Diabetic Foot Ulcers in Iran

Vahid Alipour, PhD; Aziz Rezapour, PhD; Mehdi Ebrahimi, MD; Jalal Arabloo, PhD


Wounds. 2021;33(2):50-56. 

In This Article


Base-case Analysis Results

As shown in Table 6, the expected costs per patient per year using a NPWT treatment strategy ($5165 ± 3258) were $4668 lower than those of a TWC treatment strategy ($9833 ± 5861). The corresponding QALYs were 0.1052 higher for the NPWT (8.90259) compared with TWC (8.79739). Consequently, this resulted in an ICER of - $44 370 per QALY gained. With its greater QALYs and lower costs, NPWT is considered the more effective wound treatment strategy.

Sensitivity Analysis

The Tornado diagram represents the impact on the ICER when varying each of the parameters (Figure 2). Due to the 1-year period of this study, the discount rate was considered neither in the initial analysis, nor in the sensitivity analysis. Based on the findings shown in Figure 2, cost variations had no effect on the prominence of NPWT; however, when the utility value of healed state decreased by 20%, the ICER result was $143 874.60 per QALY, which means that NPWT was placed in the first region of the cost-effectiveness plan (ie, higher cost, greater effectiveness). In this case, choosing the most cost-effective treatment option will be dependent on the maximum willingness to pay.

Figure 2.

Tornado diagram.
NPWT: negative pressure wound therapy; u: utility; c: cost; dress: traditional wound care; vac: vacuum-ssisted closure (NPWT); EV: expected value (ie, ICER); ICER: incremental cost-effectiveness ratio