Cost-effectiveness of treating deep diabetic foot ulcers with Promogran in four European countries.
OBJECTIVE
This study aimed to estimate the cost-effectiveness of treating non-superficial diabetic foot ulcers with Promogran plus good wound care (GWC) compared with GWC alone in four European countries (France, Germany, Switzerland and UK).


METHODS
An existing Markov-based health economic model of non-superficial diabetic foot ulcers was adapted to incorporate the relative efficacy of Promogran compared with GWC alone as demonstrated in a randomised controlled trial. Treatment with Promogran was modelled for a maximum of three months. Country-specific treatment costs were used to estimate the incremental cost per ulcer-free day gained over 12 months. Some parameter assumptions were changed to assess the sensitivity of the results.


RESULTS
Within the first three months of treatment, 26% of ulcers in the Promogran cohort healed compared with 20.7% in the GWC cohort. Over the 12 months, the average number of months spent in the healed state was 3.41 (GWC) and 3.75 (Promogran). Promogran treatment was found to be cost-saving in all four countries, using year 2000 Euro values.


CONCLUSIONS
Promogran with GWC may be cost-effective, perhaps even cost-saving, under a wide variety of assumptions for the treatment of neuropathic foot ulcers.


BACKGROUND
This study was funded by Ethicon Gmbh (Johnson and Johnson), Germany.
Ghatnekar
O
O
Swedish Institute for Health Economics, Lund, Sweden. og@ihe.se
Willis
M
M
Persson
U
U
D001458:Bandages / Q000191:economics*; D002483:Cellulose, Oxidized / Q000627:therapeutic use*; D003094:Collagen / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D017719:Diabetic Foot / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics* / Q000451:nursing; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D011336:Probability; D012016:Reference Values; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
D002483:Cellulose, Oxidized; D003094:Collagen