Cost-effectiveness of a Ceramide-Infused Skin Barrier Versus a Standard Barrier: Findings From a Long-Term Cost-effectiveness Analysis.
Ariel Berger, Gary Inglese, George Skountrianos and 2 others
PMID 29438140WHAT IT FOUND
Ceramide-infused ostomy barriers were projected to cost less, reduce peristomal skin complications, and give small quality-of-life gains over a modelled year in people with new fecal ostomies.
This is an economic model, not a patient trial proving better skin outcomes.
Key findings
01The model projected that, over 360 days, using the ceramide-infused barrier instead of standard barriers would lower ostomy and complication care costs by A$90,038 (US $69,329), add 174 quality-adjusted life days, and reduce peristomal skin complications by 82.
02On a per-patient basis, the model projected A$180 (US $139) in healthcare cost savings, 0.35 additional quality-adjusted life days, and 0.16 fewer peristomal skin complications with the ceramide-infused barrier.
03Across uncertainty simulations, the ceramide barrier was expected to reduce complications in 97% of runs, lower costs in 92%, reduce both in 90%, and increase quality-adjusted life days in 61%.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a cost-effectiveness model, not a trial in real patients, so the projected savings and complication reductions depend on assumptions rather than observed outcomes. The model used Australian product prices and assumed the ceramide barrier and standard barriers cost the same, so results may not apply where prices differ. The underlying trial followed patients for only 12 weeks, and the authors assumed rates and timing of complications for the rest of the year. The model did not separate colostomies from ileostomies or account for surgical approach, and it assumed fixed complication durations that may be shorter than real-world healing times. The trial did not assess one-piece pouching systems, but the model included them, so findings about one-piece use are uncertain. The study was funded by the manufacturer of the barrier, and two authors were employed by that manufacturer.
Declared interests
Hollister Incorporated funded the research. Two authors were employees of Hollister. Evidera Inc received Hollister funding for conducting the study and developing the article. One author, Tonny Karlsmark, reported no funding.
The easy way to misread this
Do not read the modelled reduction of 82 peristomal skin complications as proof that the ceramide barrier prevents skin damage in real patients. The model assumes complication rates from a short trial, fixed complication durations, and Australian product prices, and the trial did not show a significant difference in complication rates.