Cost-Effectiveness of Becaplermin Gel on Diabetic Foot Ulcer Healing

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. Methods: Data from three phase III trials were used to predict expected 1-year costs and outcomes, including the average percentage reduction from baseline in wound surface area (WSA), the direct costs of DFU therapy, and the cost per cm2 of WSA reduction. Results: At 20 weeks, the BGWC group had a statistically greater probability of complete wound closure than the GWC group (50% versus 35%; P = .015). Based on reported WSA reduction rates, DFUs in the BGWC group were predicted to close by 100% at 27 weeks, and those in the GWC group were predicted to close by 88% at 52 weeks. The GWC group had higher total estimated 1-year direct cost of DFU care ($6,809 versus $4,414) and higher cost per cm2 of wound closure ($3,501 versus $2,006). Conclusions: Becaplermin plus good wound care demonstrated economic dominance compared with GWC by providing better clinical outcomes via faster reduction in WSA and higher rates of closure at a lower direct cost.

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Cost-effectiveness of clostridial collagenase ointment on wound closure in patients with diabetic foot ulcer

Value in Health ◽

10.1016/j.jval.2014.03.1445 ◽

2014 ◽

Vol 17 (3) ◽

pp. A248

Author(s):

A.M. Gilligan ◽

D.L. Lange ◽

T.A. Motley ◽

C. Waycaster ◽

J.E. Dickerson

Keyword(s):

Cost Effectiveness ◽

Diabetic Foot ◽

Wound Closure ◽

Foot Ulcer ◽

Diabetic Foot Ulcer

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Cost-effectiveness of Platelet-Rich Plasma for Diabetic Foot Ulcer in Spain

The International Journal of Lower Extremity Wounds ◽

10.1177/1534734620903239 ◽

2020 ◽

pp. 153473462090323

Author(s):

Renata Linertová ◽

Tasmania del Pino-Sedeño ◽

Lidia-García Pérez ◽

Javier Aragón-Sánchez ◽

Isabel Andia-Ortiz ◽

...

Keyword(s):

Cost Effectiveness ◽

Usual Care ◽

Diabetic Foot ◽

Platelet Rich Plasma ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Cost Effective ◽

Manual Method ◽

The Cost ◽

Commercial Kit

This study evaluated the cost-effectiveness of platelet-rich plasma (PRP) added to usual care versus usual care alone in elderly patients with chronic diabetic foot ulcer (DFU) from the Spanish health care system perpective. A 6-state Markov model with 3-month cycles was used to estimate costs and outcomes of wound healing and risk of recurrences, infections, and amputations over 5 years. Three treatment strategies were compared: ( a) usual care plus PRP obtained with a commercial kit, ( b) usual care plus PRP obtained manually, and ( c) usual care. Data on effectiveness were taken from a recent meta-analysis. Outcomes and costs were discounted at 3% and resources were valued in 2018 euro. Compared with usual care, the PRP treatment with the manual method was more effective and less costly (dominant option), whereas the PRP treatment with the commercial kit was more effective but also more costly, with the incremental ratio being above the cost-effectiveness threshold (€57 916 per quality-adjusted life year). These results are sensitive to the price of PRP kits (a 20% discount would make the PRP treatment a cost-effective option) and effectiveness data, due to the heterogeneity of primary studies. In conclusion, PRP treatment for DFUs could be considered a cost-effective or even cost-saving alternative in Spain, depending on the method of obtaining the PRP. Despite the dominance of the manual method, its general use is limited to hospitals and specialized centers, whereas PRP kits could be used in primary care settings, but their prices should be negotiated by health authorities.

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Comparing the cost effectiveness of diabetic foot ulcer therapies

PharmacoResources ◽

10.1007/bf03309534 ◽

1995 ◽

Vol 24 (1) ◽

pp. 7-7

Keyword(s):

Cost Effectiveness ◽

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

The Cost

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Financial implications of dialysis modalities in the developing world: A Chinese perspective

Peritoneal Dialysis International ◽

10.1177/0896860819893812 ◽

2020 ◽

Vol 40 (2) ◽

pp. 193-201

Author(s):

Jing Liu ◽

David W Hutton ◽

Yonghong Gu ◽

Yao Hu ◽

Yi Li ◽

...

Keyword(s):

Cost Effectiveness ◽

Direct Cost ◽

Cost Effective ◽

The United States ◽

Direct Costs ◽

Sensitivity Analyses ◽

Base Case ◽

Published Data ◽

Life Years ◽

The Cost

Background: End-stage renal disease has been imposing a heavy economic burden on public health; however, few studies have been performed on the cost-effectiveness of dialysis modalities. We aim to estimate the cost-effectiveness of different dialysis modalities in China. Methods: Cost-effectiveness analyses were performed using Markov models based on published data of hemodialysis (HD) and peritoneal dialysis (PD) modalities in China. Sensitivity analyses were conducted to identify key variables influencing the results. Results: Over a 10-year time horizon, the base-case cost-effectiveness analysis indicated that PD-first absolutely dominated the HD-first option by gaining 0.13 more quality-adjusted life years (QALYs) and costing RMB ¥81,081 less. When using reported mortality of HD and PD from the United States, the PD-first option still dominated HD-first with higher QALYs and lower costs. Sensitivity analyses revealed that the results were more sensitive to the direct cost of HD, utility of HD, utility of PD, direct cost of PD, PD mortality, and HD mortality, while less sensitive to the indirect costs and transition probabilities. The HD utility needed to be at least 0.148 higher than PD utility for HD to be cost-effective. PD was about 72% likely to be considered cost-effective compared with HD, regardless of the willingness-to-pay for QALYs. Conclusion: PD appears to be more cost-effective than HD in China, and the major influential factors on the cost-effectiveness are the direct costs of HD, utility of HD, utility of PD, direct costs of PD, PD mortality, and HD mortality.

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Cost-effectiveness of small intestinal submucosa extracellular matrix on wound closure in patients with diabetic foot ulcer

Value in Health ◽

10.1016/j.jval.2014.03.1451 ◽

2014 ◽

Vol 17 (3) ◽

pp. A249 ◽

Cited By ~ 1

Author(s):

A.M. Gilligan ◽

C. Waycaster

Keyword(s):

Extracellular Matrix ◽

Cost Effectiveness ◽

Diabetic Foot ◽

Wound Closure ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Small Intestinal Submucosa ◽

Small Intestinal ◽

Intestinal Submucosa

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Cost–effectiveness of second-line nivolumab for platinum-treated advanced non-small-cell lung cancer

Journal of Comparative Effectiveness Research ◽

10.2217/cer-2020-0053 ◽

2020 ◽

Vol 9 (18) ◽

pp. 1301-1309

Author(s):

Longfeng Zhang ◽

Xiaofang Zeng ◽

Hongfu Cai ◽

Na Li ◽

Maobai Liu ◽

...

Keyword(s):

Lung Cancer ◽

Cost Effectiveness ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

Phase Iii ◽

Second Line ◽

Small Cell Lung ◽

The Cost ◽

Quality Adjusted Life

Aim: To analyze the economic impact of nivolumab and chemotherapy in patients with non-small-cell lung cancer (NSCLC) who developed disease progression after platinum-containing dual-drug chemotherapy. Materials & methods: The partitioned survival model was used to analyze the cost-utility of two NSCLC treatments by nivolumab and docetaxel. The clinical data resulted from the Phase III clinical trial. The cost parameters were derived from our previous studies, and the utility parameters were derived from the literature. Results: The quality-adjusted life-years of nivolumab and docetaxel were 0.778 and 0.336. The lifetime direct medical expenses of nivolumab and docetaxel were US$44,707.17 and US$12,826.72. The incremental cost–effectiveness ratio was $72,127.71/quality-adjusted life-year. Conclusion: The combination of chemotherapy, nivolumab is not a cost-effective choice in the second-line treatment of NSCLC.

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