Impact on Cost: Adhesive Foam Wound Dressing Comparisons in Home Care, Long-Term Care, and Hospital Settings

IntroductionBackground: Proper management of exuding wounds is paramount to optimal wound healing. Fluid handling capacity, including absorption and breathability, as well as dressing size and conformability are critical factors in determining the most appropriate wound dressing. Acute and chronic wounds can be challenging and costly to manage. Ideally, foam adhesive dressings should be able to optimize the moist wound environment and reduce the cost burden associated with their use.

Objective: Three models were developed to estimate the economic impact of various foam adhesive dressings being used in home care, long-term care, and hospital settings.

Methods: An economic model was developed using inputs of: ● Dressing and supply cost from HPIS/Global Healthcare Exchange ● Dressing wear time based on healthy human studies using artificial wound fluid simulating a moderate to high-exudating wound

● Nursing labor cost based on RN Bureau of Labor Statistics ● Dressing change time in minutes based on expert opinion

Costs were calculated for a 60-day treatment period for home care, 30-day treatment period for long term care, and 7-day treatment period for hospital settings.

AcknowledgementsPoster design by Lutz Consulting LLC

This study was supported by 3M Health Care

References:1. HPIS/Global Healthcare Exchange for dressing and supplies cost.2. 3M Healthcare studies 05-011239, 05-011246, 05-011247, 05-011248, 05-011289, 05-

011326. Data on file at 3M.3. Median RN per visit cost: National Association for Home Care & Hospice, Hospital &

Healthcare Compensation Service. Homecare Salary & Benefits Report 2006-2008. October 2007.

4. Expert opinion.5. Median hourly RN labor cost for Long-Term-Care & Hospital facilities, Bureau of Labor

Statistics.

Angeline Carlson*, Cheryl L. Loegering†, Cindy Zehrer†, and Shelley-Ann Walters†

*University of Minnesota, College of Pharmacy, Minneapolis, MN, USA, †3M Health Care, St. Paul, MN, USA

A) A non-stick pad was cut to the desired width but double the length of final wound size. B) The catheter tip was inserted into the folded pad. C) The pad was taped into a sandwich around the catheter using a strip of paper tape and gently adhered to the test site. D) The test dressing was applied over the wound model. E) Catheter tubing was secured with transparent dressings, providing easy access to the catheter hub. F) The catheter hub/plug was secured with a strip of cloth tape. G) Artificial wound fluid (0.1 ml) was injected into the model 12X per day at hourly intervals. H) Finished wound models showing details of the model through a transparent absorbent dressing.

Dressings were assessed until failure for up to 7 days of wear. Failure was defined as

dressing fall-off, adhesive border lift sufficient to cause leakage, migration or delamination of dressing layers.

Home Care Long-Term Care Hospital

Conclusions

Model Assumptions: ● Modeling was based on inputs (assumptions) for dressing cost,1 dressing wear time,2 supplies cost,1 nursing care costs,3 and dressing change time.4

● Treatment period was estimated to be 60 consecutive days. ● Wear time for each dressing was based on artificial wound model studies that measured wear time under simulated moderate to high-exudate conditions over a 7-day period (Figure 1).2

Summary of Model Inputs:

Figure 1: Artificial Wound Model Procedure:

General Model Inputs Base Cost AssumptionDressing supply cost (3 gloves, wound cleanser)1

Median RN cost per visit3

Dressing change time (minutes)4

Treatment period (days)

$1.35$33.00

2060

* Dressing FootnotesDressing A: 3M™ Tegaderm™ High Performance Foam Adhesive Dressing Dressing C: Smith & Nephew Allevyn™ Adhesive Dressing Dressing E: Molnlycke Mepilex® Border Dressing Dressing G: Smith & Nephew Allevyn™ Gentle Border DressingDressinf B: Coloplast Biatain® Foam Adhesive Dressing Dressing D: Medline Optifoam® Adhesive Dressing Dressing F: Convatec Versiva® XC® Adhesive Dressing *Data reflects the dressings on the market at the time the studies were completed before March, 2010

Model Assumptions: ● Modeling was based on inputs (assumptions) for dressing cost,1 dressing wear time,2 supplies cost,1 nursing care costs,5 and dressing change time.4

● Treatment period was estimated to be 30 consecutive days. ● Wear time for each dressing was based on artificial wound model studies that measured wear time under simulated moderate to high-exudate conditions over a 7-day period (Figure 1).2

Summary of Model Inputs:General Model Inputs Base Cost AssumptionDressing supply cost (1 biohazard bag, 3 gloves, wound cleanser)1

Median RN cost (per hour)5

Dressing change time (minutes)4

Labor cost per dressing changeTreatment period (days)

$1.89$27.20

20$9.07

30

$-

$100

$200

$300

$400

$500

$600

$700

$800

$900

A B C D E F G

Foam Dressing ID Code

Cost Per Patient During 60 Day Treatment Period

$-

$200

$400

$600

$800

$1,000

$1,200

$1,400

$1,600

$1,800

A B C D E F G

$219 

$496  $518 

$661 

$794 

$1,387 

$1,666 

Foam Dressing ID Code

Cost Per Patient During 60 Day Treatment Period

Model Assumptions: ● Modeling was based on inputs (assumptions) for dressing cost,1 dressing wear time,2 supplies cost,1 nursing care costs,5 and dressing change time.4

● Treatment period was estimated to be 7 consecutive days. ● Wear time for each dressing was based on artificial wound model studies that measured wear time under simulated moderate to high-exudate conditions over a 7-day period (Figure 1).2

Summary of Model Inputs:

$-

$15

$30

$45

$60

$75

$90

$105

$120

$135

A B C D E F G

● Results of this economic model show that the projected longer wear times for Dressing A result in considerable material and labor cost savings. ● Results of this economic model show potential cost savings of using Dressing A over the other dressings range from:

⇒ Home Care: $27,689 to $144,677 per 100 patients annually. ⇒ Long-Term Care: $13,163 to $67,607 per 100 patients annually. ⇒ Hospital: $8,164 to $48,880 per 500 patients annually.

Facility Cost Per 100 Patients

A B C D E F G

$180,000

$160,000

$140,000

$120,000

$100,000

$80,000

$60,000

$40,000

$20,000

$0

Cos

t (U

S D

olla

rs)

Foam Dressing ID Code

$166,600

$138,683

$79,367$66,053

$51,798$49,622

$21,933

A B C D E F G

Foam Dressing ID Code

$1,800

$1,600

$1,400

$1,200

$1,000

$800

$600

$400

$200

$0

Cos

t (U

S D

olla

rs)

Cost Per Patient During 60 Day Treatment Period

$219

$496 $518

$661$794

$1,387

$1,666

A B C D E F G

Foam Dressing ID Code

$900

$800

$700

$600

$500

$400

$300

$200

$100

$0

Cos

t (U

S D

olla

rs)

Cost Per Patient During 30 Day Treatment Period

$115

$247 $246

$316

$395

$659

$791

Facility Cost Per 100 Patients

A B C D E F G

$90,000

$80,000

$70,000

$60,000

$50,000

$40,000

$30,000

$20,000

$10,000

$0

Cos

t (U

S D

olla

rs)

Foam Dressing ID Code

$79,130

$65,867

$39,464

$31,637

$24,648$24,727

$11,523

A B C D E F G

Foam Dressing ID Code

$135

$120

$105

$90

$75

$60

$45

$30

$15

$0

Cost Per Patient During 7 Day Treatment Period

$16

$49

$33

$51 $52

$102

$114

Facility Cost Per 500 Patients

A B C D E F G

$63,000

$56,000

$49,000

$42,000

$35,000

$28,000

$21,000

$14,000

$7,000

$0

Cos

t (U

S D

olla

rs)

Foam Dressing ID Code

$57,003

$50,900

$26,110$25,750

$16,287

$24,535

$8,123

Cos

t (U

S D

olla

rs)

Dressing Inputs* Unit CostWear Time

(Days)Dressings Required Per

Treatment PeriodDressing ADressing BDressing CDressing DDressing EDressing FDressing G

$12.09$13.77$16.43$20.68$19.40$15.39$15.42

7.03.23.53.02.51.21.0

510910132530

General Model Inputs Base Cost AssumptionDressing supply cost (1 biohazard bag, 3 gloves, wound cleanser)1

Median RN cost (per hour)5

Dressing change time (minutes)4

Labor cost per dressing changeTreatment period (days)

$1.78$30.71

20$10.24

7

Dressing Inputs* Unit CostWear Time

(Days)Dressings Required Per

Treatment PeriodDressing ADressing BDressing CDressing DDressing EDressing FDressing G

$4.23$4.34$4.27$5.15$5.39$4.95$4.27

7.03.23.53.02.51.21.0

1323367

Dressing Inputs* Unit CostWear Time

(Days)Dressings Required Per

Treatment PeriodDressing ADressing BDressing CDressing DDressing EDressing FDressing G

$12.09$13.77$16.43$20.68$19.40$15.39$15.42

7.03.23.53.02.51.21.0

9191820255060

A B

C D

E

G

F

H