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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
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 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.
Keywords: lymphaticovenous anastomosis (LVA); Lymphoedema; Cost-effectiveness; Cellulitis; Quality of Life
College: Faculty of Medicine, Health and Life Sciences
Funders: Funding for the analysis was supplied by Swansea Bay University Health Board (SBUHB).
Start Page: 42
End Page: 49

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