Cost-Effectiveness of Becaplermin Gel on Diabetic Foot Ulcer Healing

Abstract

Background: A comparison of the cost-effectiveness of becaplermin plus good wound care (BGWC) versus good wound care (GWC) alone in treating patients with diabetic foot ulcers (DFUs) may enable physicians and health-care decision makers in the United States to make better-informed choices about treating DFUs, which currently contribute to a substantial portion of the economic burden of diabetes.

Cost-effectiveness of using adjunctive porcine small intestine submucosa tri-layer matrix compared with standard care in managing diabetic foot ulcers in the US

“…21 Despite these statistics, there have only been a limited number of economic analyses comparing alternative treatments with standard care for the management of DFUs in the US. [22][23][24][25][26][27][28] The findings from these analyses pertaining to standard care are concordant with the findings of the present study, which showed that use of adjunctive SIS instead of standard care alone has the potential to improve outcomes for patients and reduce the burden imposed by DFUs to third-party payers. Nevertheless, generalising the findings from this study to other health-care systems would be challenging, since resource use and the manner in which resources are reimbursed by Medicare in the US would undoubtedly be different from that in other countries.…”

Economic evaluations considering costs and outcomes of diabetic foot ulcer infections: A systematic review

“…Nineteen studies were included in the final analysis. All papers [41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59] were full economic evaluations considering and comparing the costs and benefits of interventions against comparators.…”

“…Patients across all age groups 18 years and over were captured. Four cohorts were derived from clinical trials [44,50,57,58] and some studies focused on moderate to severe, [48,[55][56][57] or non-healing [44] DFUs only. DFU infection was a part of the clinical presentation or model pathway in all studies.…”

“…The economic perspective taken by each study determines the cost and benefits included. [17] The societal perspective was taken by Cárdenas et al [41] and Redekop et al [54] The perspective of the healthcare system was taken in six studies [42,43,50,55,57,59] and the payers perspective was taken in five [45,46,49,56,58] (Table 2). Both the societal and payers perspectives were taken by Guo et al [48] Perspective was not reported in five studies, [44,47,[51][52][53] however Ortegon et al [51] discussed some results from the policy and clinical perspective.…”

Clinical Translational Potential in Skin Wound Regeneration for Adipose-Derived, Blood-Derived, and Cellulose Materials: Cells, Exosomes, and Hydrogels

“…There have been considerable advancements in the understanding of the biochemical pathways and mechanisms underlying skin regenerative therapies, leading to explorations into the use of cells and cell-derived cytokines and exosomes, as well as hydrogels (recently reviewed in [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]) ( Table 1 ). While decellularized dermal scaffolds are routinely employed [ 20 ], only a PDGF (Platelet Derived Growth Factor)-related product has received regulatory approval among the cytokines, while no cell therapy has widespread approval in the U.S. [ 21 , 22 ]. Thus, rather than reliance on sophisticated biologics, the current standard of care for skin wounds continues to employ preventive measures and surgical interventions involving debridement, autologous skin grafts, or the introduction of decellularized allogeneic or xenogeneic biological scaffolds.…”