Cost-effectiveness of a Ceramide-Infused Skin Barrier Versus a Standard Barrier

Abstract

PURPOSE:To assess the cost-effectiveness of a ceramide-infused skin barrier (CIB) versus other skin barriers (standard of care) among patients who have undergone ostomy creation.DESIGN:Cost-effectiveness analysis, based on a decision-analytic model that was estimated using data from the ADVOCATE (A Study Determining Variances in Ostomy Skin Conditions And The Economic Impact) trial, which investigated stoma-related healthcare costs over 12 weeks among patients who recently underwent fecal ostomy, and from other sources.SUBJECTS AND SETTING:Analysis was based on a hypothetical cohort of 1000 patients who recently underwent fecal ostomy; over a 1-year period, 500 patients were assumed to use CIB and 500 were assumed to use standard of care.METHODS:We adapted a previous economic model to estimate expected 1-year costs and outcomes among persons with a new ostomy assumed to use CIB versus standard of care. Outcomes of interest included peristomal skin complications (PSCs) (up to 2 during the 1-year period of interest) and quality-adjusted life days (QALDs); QALDs vary from 1, indicating a day of perfect health to 0, indicating a day with the lowest possible health (deceased). Subjects were assigned QALDs on a daily basis, with the value of the QALD on any given day based on whether the patient was experiencing a PSC. Costs included those related to skin barriers, ostomy accessories, and care of PSCs. The incremental cost-effectiveness of CIB versus standard of care was estimated as the incremental cost per PSC averted and QALD gained, respectively; net monetary benefit of CIB was also estimated. All analyses were run using the perspective of an Australian payer.RESULTS:On a per-patient basis, use of CIB was expected over a 1-year period to result in 0.16 fewer PSCs, an additional 0.35 QALDs, and a savings of A$180 (Australian dollars, US $137) in healthcare costs all versus standard of care. Management with CIB provided a net monetary benefit (calculated as the product of maximum willingness to pay for 1 QALD times additional QALDs with CIB less the incremental cost of CIB) of A$228 (US $174). Probabilistic sensitivity analysis was also completed; it revealed that 97% of model runs resulted in fewer expected PSCs with CIB; 92% of these runs resulted in lower expected costs with CIB.CONCLUSIONS:Findings suggest that the CIB is a cost-effective skin barrier for persons living with an ostomy.

Clinical significance of the water retention and barrier function‐improving capabilities of ceramide‐containing formulations: A qualitative review

“…Finally, after the second round of screening, 41 papers were found to discuss the moisturizing and barrier improvement effects of the application of ceramide‐containing formulations on human skin (Table 1 ). 13 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 PICO and effect‐index similarity analyses were performed for these 41 papers.…”

A Cost-Effectiveness Model to Determine Ostomy-Related Costs of Care and Health Outcomes Among People With an Ostomy in Canada Using a Ceramide-Infused Skin Barrier

“…We adapted a previous cost-effectiveness model that was developed to determine the ostomy-related cost of care and outcomes among persons with a new ostomy assumed to use a CIB versus SOC. 1 , 4 The ADVOCATE trial investigated ostomy-related health care costs over 12 weeks post-ostomy surgery in a group of 153 patients from 25 sites located in Canada, Europe, and the United States. Participants were randomly allocated using a block randomization and adaptive design.…”

“…A ceramide-infused ostomy skin barrier is an example of a novel technology for ostomy products created with a focus on skin health. 4 Ceramides are extracellular lipids that are found in the stratum corneum. They play a key role in multiple functions of the skin including barrier function, renewal of skin layers, and immune functions.…”

Calidad de vida en personas portadoras de una ostomía digestiva.

“…Se encontraron 19 estudios en los que se menciona la afectación directa de la calidad de vida de las personas ostomizadas a causa de los tratamientos médicoquirúrgicos e intervenciones de enfermería efectuados para disminuir las complicaciones de la ostomía (35)(36)(37)(38)(39)(40)(41)(42)(43)(44), la necesidad de contar con profesionales de enfermería entrenados en el manejo de los dispositivos de barrera para garantizar una adecuada educación y entrenamiento en el cuidado de la ostomía (45)(46)(47)(48), además de aspectos psicológicos, sexuales y religiosos relacionados con la presencia de la ostomía, los cuales generan alteración en el rol laboral y social, rechazo y problemas de exclusión en algunas poblaciones específi cas, cuya cultura difi culta vivir en sociedad con un estoma digestivo (49)(50)(51)(52).…”

“…Dispositivos de barrera-Rentabilidad, uso, evaluación a las enfermeras que atiende el estoma, tecnologías con silicona (45)(46)(47)(48). Aspectos psicológicos y sexualidad -Atención psicosocial por las enfermeras que atienden el estoma, aspectos psicológicos generados por la presencia del estoma (49)(50)(51).…”