Negative pressure wound therapy for surgical wounds healing by secondary intention is not cost-effective

Background Negative Pressure Wound Therapy (NPWT) has been used in clinical practice for the treatment of surgical wounds healing by secondary intention (SWHSI), despite limited evidence regarding its clinical and cost-effectiveness. This study aimed to evaluate the cost-effectiveness of NPWT for SWHSI, compared to standard dressings, from the perspective of the UK healthcare system. Methods An economic model was used to extrapolate the effectiveness results of a meta-analysis over a patient’s lifetime and estimate the costs and outcomes (quality-adjusted life-years (QALYs)) of NPWT and standard dressings. The probability of NPWT being cost-effective was estimated, with extensive scenario analyses conducted to evaluate the robustness of results and the degree of uncertainty. Results On average, NPWT was associated with higher costs and marginally higher QALYs than standard dressings. The cost difference was mainly driven by the additional intervention costs implied by NPWT. The estimated probability of NPWT being cost-effective was under 30%. There was considerable uncertainty in the findings driven largely by uncertainty in the estimated pooled relative effect from the meta-analysis. Results were robust to different scenario analyses. Conclusions No evidence was found demonstrating that NPWT was a cost-effective alternative to standard dressings for the treatment of SWHSI.