Gee Kee, E1, Stockton, K1, Kimble, RM1,3, Cuttle, L1,2, McPhail, SM4,5
1Centre for Children’s Burns and Trauma Research, Child Health Research Centre, The University of Queensland
2Tissue Repair and Regeneration Program, Institute of Health and Biomedical Innovation, Queensland University of Technology
3Pegg Leditschke Children’s Burns Centre, Lady Cilento Children’s Hospital, Brisbane
4Institute of Health and Biomedical Innovation and School of Public Health & Social Work, Queensland University of Technology
5Centre for Functioning and Health Research, Metro South Health
Paediatric partial thickness burns up to 10% TBSA are common injuries primarily treated in the outpatient setting using expensive silver-containing dressings. However, economic evaluations are lacking to assist healthcare providers when choosing which dressing to use. This study aimed to conduct an incremental cost-effectiveness (ICER) analysis of three silver dressings for partial thickness burns ≤10% TBSA in children aged 0-15 years using days to full wound re-epithelialization as the health outcome.
This study was a trial based economic evaluation (ICER) conducted from a healthcare provider perspective. Ninety-six children participated in the trial investigating Acticoat™, Acticoat™ with Mepitel™ or Mepilex Ag™. Costs directly related to the management of partial thickness burns ≤10% TBSA were collected during the trial from March 2013-July 2014 and for one year post re-epithelialization. ICERs were estimated and dominance probabilities calculated from bootstrap resampling trial data. Sensitivity analyses were conducted to examine the potential effect of infrequent, but high cost, skin grafting procedures.
Costs (dressing, labour, analgesics, scar management) were considerably lower in the Mepilex Ag™ group (median AUD$94.45) compared to the Acticoat™ (median $244.90) and Acticoat™ with Mepitel™ (median $196.66) groups. There was a 99% and 97% probability that Mepilex Ag™ was cheaper and more effective than Acticoat™ and Acticoat™ with Mepitel™, respectively. This pattern of dominance was consistent across raw cost and effects, after a-priori adjustments, and sensitivity analyses.
This trial-based economic evaluation has demonstrated that Mepilex Ag™ was the dominant dressing choice over both Acticoat™ and Acticoat™ with Mepitel™.
Emma Gee Kee is an occupational therapist at Lady Cilento Children’s Hospital, Brisbane who recently completed her PhD with the Centre for Children’s Burns and Trauma Research team and The University of Queensland. Her research studies focused on the treatment and outcomes for children who sustain partial thickness burn injuries.