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Cost-effectiveness analysis of lymphaticovenous anastomosis in reducing cellulitis recurrence in 150 lymphoedema cases followed-up over 24 months

Ioan Humphreys Orcid Logo, M. Thomas Orcid Logo, C. Pike Orcid Logo, K. Morgan, Z. Jessop, T. Bragg Orcid Logo, A. Ghattaura

Journal of Plastic, Reconstructive & Aesthetic Surgery, Volume: 106, Pages: 42 - 49

Swansea University Author: Ioan Humphreys Orcid Logo

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DOI (Published version): 10.1016/j.bjps.2025.04.032

Abstract

Background: Lymphoedema is a chronic condition initiating ongoing costs on the patient and the National Health Service (NHS).This study aimed to estimate the cost-effectiveness of LVA in reducing cellulitis recurrence for 150 lymphoedema cases followed up over 24-months. Methods: Data were prospecti...

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Published in: Journal of Plastic, Reconstructive & Aesthetic Surgery
ISSN: 1748-6815 1878-0539
Published: Elsevier BV 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa69371
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Methods: Data were prospectively captured prior and post LVA surgery on 150 unilateral lower or upper limb lymphoedema patients in one centre in the UK. Data collection included cellulitis resource utilisation with costs identified from the British National Formulary, Personal Social Services Research Unit, and a quality of life questionnaire (EQ-5D-5L). Results: The mean overall costs for cellulitis and hospital admissions reduced by &#xA3;1,389.85 which was statistically significant (p &lt;0.001). Mean per patient reduction costs across the 24-months were estimated at -&#xA3;1,405.62 (CI:-&#xA3;1,878.09,-&#xA3;933.16). When the cost of LVA (&#xA3;4,551) was included, the reductions were offset to &#xA3;3,145.37 (CI: &#xA3;2,672.90, &#xA3;3,617.84).The mean EQ-5D-5L utility score (n=143) increased from 0.743 (SD 0.168) to 0.800 (SD 0.196) being statistically significant (p = &lt;0.001). The incremental cost effectiveness ratio (ICER) through costs and EQ-5D-5L changes was &#xA3;54,231, indicating that LVA costs more, but is more effective. LVA benefits patients for longer than the 24-months captured, thus costs would be reduced based on patients&#x2019; life expectancy. 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spelling 2025-05-19T13:51:52.9959939 v2 69371 2025-04-30 Cost-effectiveness analysis of lymphaticovenous anastomosis in reducing cellulitis recurrence in 150 lymphoedema cases followed-up over 24 months 399e932224d259fca801505dc92cebf7 0000-0001-7993-0179 Ioan Humphreys Ioan Humphreys true false 2025-04-30 HSOC Background: Lymphoedema is a chronic condition initiating ongoing costs on the patient and the National Health Service (NHS).This study aimed to estimate the cost-effectiveness of LVA in reducing cellulitis recurrence for 150 lymphoedema cases followed up over 24-months. Methods: Data were prospectively captured prior and post LVA surgery on 150 unilateral lower or upper limb lymphoedema patients in one centre in the UK. Data collection included cellulitis resource utilisation with costs identified from the British National Formulary, Personal Social Services Research Unit, and a quality of life questionnaire (EQ-5D-5L). Results: The mean overall costs for cellulitis and hospital admissions reduced by £1,389.85 which was statistically significant (p <0.001). Mean per patient reduction costs across the 24-months were estimated at -£1,405.62 (CI:-£1,878.09,-£933.16). When the cost of LVA (£4,551) was included, the reductions were offset to £3,145.37 (CI: £2,672.90, £3,617.84).The mean EQ-5D-5L utility score (n=143) increased from 0.743 (SD 0.168) to 0.800 (SD 0.196) being statistically significant (p = <0.001). The incremental cost effectiveness ratio (ICER) through costs and EQ-5D-5L changes was £54,231, indicating that LVA costs more, but is more effective. LVA benefits patients for longer than the 24-months captured, thus costs would be reduced based on patients’ life expectancy. Conclusion: This cost-effectiveness analysis has provided an in-depth examination on a large cohort of LVA patients followed up for 24-months highlighting decreased cellulitis recurrence. Journal Article Journal of Plastic, Reconstructive &amp; Aesthetic Surgery 106 42 49 Elsevier BV 1748-6815 1878-0539 lymphaticovenous anastomosis (LVA); Lymphoedema; Cost-effectiveness; Cellulitis; Quality of Life 1 7 2025 2025-07-01 10.1016/j.bjps.2025.04.032 COLLEGE NANME Health and Social Care School COLLEGE CODE HSOC Swansea University SU Library paid the OA fee (TA Institutional Deal) Funding for the analysis was supplied by Swansea Bay University Health Board (SBUHB). 2025-05-19T13:51:52.9959939 2025-04-30T12:08:03.8685921 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Therapies Ioan Humphreys 0000-0001-7993-0179 1 M. Thomas 0000-0001-6631-9629 2 C. Pike 0000-0002-8922-7070 3 K. Morgan 4 Z. Jessop 5 T. Bragg 0000-0003-1427-8639 6 A. Ghattaura 7 69371__34305__a072b6fa6aa9498e91b9873d63b30c08.pdf 69371.VoR.pdf 2025-05-19T13:49:30.2346178 Output 431777 application/pdf Version of Record true © 2025 The Authors. This is an open access article under the CC BY license. true eng http://creativecommons.org/licenses/by/4.0/
title Cost-effectiveness analysis of lymphaticovenous anastomosis in reducing cellulitis recurrence in 150 lymphoedema cases followed-up over 24 months
spellingShingle Cost-effectiveness analysis of lymphaticovenous anastomosis in reducing cellulitis recurrence in 150 lymphoedema cases followed-up over 24 months
Ioan Humphreys
title_short Cost-effectiveness analysis of lymphaticovenous anastomosis in reducing cellulitis recurrence in 150 lymphoedema cases followed-up over 24 months
title_full Cost-effectiveness analysis of lymphaticovenous anastomosis in reducing cellulitis recurrence in 150 lymphoedema cases followed-up over 24 months
title_fullStr Cost-effectiveness analysis of lymphaticovenous anastomosis in reducing cellulitis recurrence in 150 lymphoedema cases followed-up over 24 months
title_full_unstemmed Cost-effectiveness analysis of lymphaticovenous anastomosis in reducing cellulitis recurrence in 150 lymphoedema cases followed-up over 24 months
title_sort Cost-effectiveness analysis of lymphaticovenous anastomosis in reducing cellulitis recurrence in 150 lymphoedema cases followed-up over 24 months
author_id_str_mv 399e932224d259fca801505dc92cebf7
author_id_fullname_str_mv 399e932224d259fca801505dc92cebf7_***_Ioan Humphreys
author Ioan Humphreys
author2 Ioan Humphreys
M. Thomas
C. Pike
K. Morgan
Z. Jessop
T. Bragg
A. Ghattaura
format Journal article
container_title Journal of Plastic, Reconstructive &amp; Aesthetic Surgery
container_volume 106
container_start_page 42
publishDate 2025
institution Swansea University
issn 1748-6815
1878-0539
doi_str_mv 10.1016/j.bjps.2025.04.032
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Therapies{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Therapies
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description Background: Lymphoedema is a chronic condition initiating ongoing costs on the patient and the National Health Service (NHS).This study aimed to estimate the cost-effectiveness of LVA in reducing cellulitis recurrence for 150 lymphoedema cases followed up over 24-months. Methods: Data were prospectively captured prior and post LVA surgery on 150 unilateral lower or upper limb lymphoedema patients in one centre in the UK. Data collection included cellulitis resource utilisation with costs identified from the British National Formulary, Personal Social Services Research Unit, and a quality of life questionnaire (EQ-5D-5L). Results: The mean overall costs for cellulitis and hospital admissions reduced by £1,389.85 which was statistically significant (p <0.001). Mean per patient reduction costs across the 24-months were estimated at -£1,405.62 (CI:-£1,878.09,-£933.16). When the cost of LVA (£4,551) was included, the reductions were offset to £3,145.37 (CI: £2,672.90, £3,617.84).The mean EQ-5D-5L utility score (n=143) increased from 0.743 (SD 0.168) to 0.800 (SD 0.196) being statistically significant (p = <0.001). The incremental cost effectiveness ratio (ICER) through costs and EQ-5D-5L changes was £54,231, indicating that LVA costs more, but is more effective. LVA benefits patients for longer than the 24-months captured, thus costs would be reduced based on patients’ life expectancy. Conclusion: This cost-effectiveness analysis has provided an in-depth examination on a large cohort of LVA patients followed up for 24-months highlighting decreased cellulitis recurrence.
published_date 2025-07-01T05:29:23Z
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