Disposable Negative Pressure Wound Therapy: A Solution for Significantly Reducing the Cost of NPWT

Gary Delhougne, JD, MHA1, Christopher Hogan, PhD2, Kim Tarka, BA1 and Sunitha Nair, MD, FACPWA3, (1)Smith & Nephew, Inc., Fort Worth, TX, (2)Direct Research, LLC., Vienna, VA, (3)St. Francis Wound Healing Center, Evanston, IL
Background: Negative pressure wound therapy (NPWT) has been shown to facilitate wound closure, reduce wound complications and reduce the number of dressing changes compared to standard wound care. As the use of traditional NPWT (tNPWT) increased, costs to Centers for Medicare and Medicaid Services (CMS) also increased. From 2001 to 2007, payments for tNPWT increased from $24 million to $164 million. Disposable NPWT (dNPWT) has been shown to deliver equivalent outcomes compared to tNPWT. We compared the costs and treatment episode lengths associated with tNPWT and dNPWT in patients requiring NPWT.

Methods: NPWT patient data were extracted from the 2012–2014 CMS Limited Data Set Standard Analytic File (LDS SAF) and divided into 2 mutually exclusive groups: patients who received tNPWT and patients who received dNPWT. Each NPWT episode was initiated by a CMS claim for a NPWT device and continued until there was a break >31 days between claims. NPWT episode length was calculated as the average interval between device claims; for episodes with only 1 NPWT device, episode length was based on the average interval for all patients with NPWT. NPWT costs were defined as CMS payments (US 2013 dollars) for NPWT supplies and services.

Results: 2938 patients received tNPWT and 3522 received dNPWT. The average cost per tNPWT episodes was $4650 versus $1532 for dNPWT. Mean length of tNPWT episode was 43.3 days versus 28.3 days for dNPWT. Sensitivity analyses demonstrated cost savings were not impacted by wound or comorbidity characteristics, but were reduced modestly when repriced at 2016 rates.

Conclusion: The cost of dNPWT is one-third the cost of tNPWT. Given the incidence of NPWT use in the United States, we estimate that CMS could realize costs savings of more than $1 billion over a 10-year period if patients use dNPWT over tNPWT for wound care.