The cost effectiveness of electrical stimulation therapy compared to standard wound care was explored in a recent study (Mittman et al. 2011; Canada). A decision analytic model was constructed to investigate the cost per pressure ulcer healed over a one year timeframe. Healing rates with electrical stimulation therapy and standard wound care were based on a randomized controlled trial. Recurrence of pressure ulcers and complications such as infections and osteomyelitis were included in the model. Taking into consideration the cost of complications, the total cost of electrical stimulation therapy at one year was modelled to be less than standard wound care treatment. Electrical stimulation therapy also resulted in more pressure ulcers healed. Thus, in the base case, electrical stimulation therapy had lower costs and better outcomes and as a result was the dominant strategy. However, the cost difference between the interventions was small and is sensitive to the percentage of pressure ulcers healed. The limitation in the study includes the small sample size that the efficacy outcomes were based on. However, this is typical of studies using an SCI population where the prevalence is small. A second limitation was the short 1-year timeframe of the model.
Overall the authors concluded that electrical stimulation appears to be a cost-effective strategy over one year compared to standard wound care. However, this needs to be interpreted with caution given the model’s sensitivity to the clinical trial outcomes.
For a single study, over a one year timeframe, electrical stimulation in addition to standard wound care had lower costs and greater number of wounds healed.