Cost-effectiveness analysis of the geko™ device (an NMES technology) in managing venous leg ulcers in UK healthcare setting

Abstract Objective This study evaluates the cost-effectiveness of the geko device a neuromuscular electro-stimulator (NMES) technology with standard of care versus standard of care alone for venous leg ulcers treatment, from the UK National Health Service perspective over 12 months. Setting Research was conducted across NHS UK facilities, primarily within community services and outpatient leg ulcer clinics, encompassing a total of 51 patients. Method A partitioned survival model, based on a two-arm randomised controlled trial, assessed wound healing rates using Kaplan–Meier curves and parametric extrapolations over a 12-month time horizon. Costs were derived from UK reference costs the British National Formulary, and the Personal Social Services Research Unit (2021/22). The primary outcome measured was the incremental cost per quality-adjusted life-year gained. The geko device provides additional benefits by stimulating the lateral popliteal nerve, augmenting venous, arterial and microvascular flow. Results The addition of the geko device to standard of care significantly enhanced outcomes, increasing healing probability by 68% compared to standard of care. This integration would result in a cost saving of £774.14 per patient when compared to the standard of care alone across the NHS. Economic analyses indicate that integrating the geko device into standard of care protocols would reduce the overall NHS expenditure on venous leg ulcer wound management by as much as 15%. The approach also positively impacted health-related quality of life. Conclusion The geko™ device when used adjunctively with standard of care would be a cost-effective method for managing chronic venous leg ulcers within the NHS, improving healing rates and offering economic benefits. Key messages Enhanced Healing Rates The addition of the geko™ device (an NMES technology) to standard of care significantly increases the probability of healing in patients with chronic venous leg ulcers. Economic Advantage Incorporating the geko device into standard of care would lead to a reduction in the overall costs of wound management in the NHS, potentially up to 15%. Cost-Effectiveness The combination of the geko device and standard of care demonstrates cost-effectiveness, offering a favourable balance between costs and quality-adjusted life years gained. Improved Quality of Life The use of the geko device in addition to standard of care impacts positively the health-related quality of life for patients. Consistent Outcomes in Sensitivity Analysis Sensitivity analyses support the cost dominance of the combined treatment approach, indicating robustness in various scenarios. Policy Implications These findings suggest that the integration of the geko device technology would be a viable policy option for enhancing venous leg ulcer treatment within the NHS.