Model-Based Financial Consequences of Electrical Stimulation Therapy for Pressure Injury Healing

Background: Electrical stimulation (ES) is recommended as an adjunctive therapy for pressure injuries (PIs), but adoption requires implementation-relevant estimates of facility-level budget impact, including delivery costs. Methods: We conducted a model-based financial consequence analysis (provider perspective, Japan) using a 14-day randomized double-blind crossover trial (n = 12). Baseline time to heal under placebo (T_placebo) was imputed from published median healing times stratified by DESIGN-R category and PI depth. A ratio-based healing acceleration parameter (r; treated as a secondary translation parameter) was used to estimate time to heal under ES (T_ES = T_placebo/r) and days saved. Days saved were valued as a modeled gross offset using JPY 4000/day as a healing-related monetary value proxy; ES implementation costs comprised device allocation, consumables, and incremental staff time; and uncertainty was propagated via 10,000 patient-level bootstrap resamples. Results: The primary crossover effect was Δ = 0.128 cm²/day (ES minus placebo; p = 0.008), and r was 3.52 (95% uncertainty interval [UI] 1.53-13.67). Under the base-case modeled translation, mean T_placebo was 177.3 days and mean T_ES was 50.4 days, yielding 126.9 days saved (95% UI 63.5-164.9). The modeled gross offset (proxy-based) was JPY 507,723/case (95% UI 253,854-659,434). Mean implementation cost was JPY 47,794/case, giving a net financial impact (proxy-based) of JPY 459,929/case (95% UI 158,459-640,086). Conclusions: Under the base-case-modeled assumptions, ES may be cost offsetting when healing-related care is valued using a monetary value proxy. However, prospective studies directly measuring time to heal and resource use are warranted.