title: Cost-Effectiveness of Becaplermin Gel on Diabetic Foot Ulcer HealingChanges in Wound Surface Area.
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.
  
  
  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 cm(2) 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 cm(2) 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.
authors.forename: Curtis R
authors.initials: CR
authors.lastname: Waycaster
authors.forename: Adrienne M
authors.initials: AM
authors.lastname: Gilligan
authors.forename: Travis A
authors.initials: TA
authors.lastname: Motley
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000077214:Becaplermin; D017326:Clinical Trials, Phase III as Topic; D003362:Cost-Benefit Analysis; D017719:Diabetic Foot / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics*; D005260:Female; D005782:Gels; D006801:Humans; D008297:Male; D008875:Middle Aged; D020574:Proto-Oncogene Proteins c-sis / Q000191:economics* / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012720:Severity of Illness Index; D017592:Skin Care / Q000191:economics* / Q000379:methods; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects / Q000502:physiology
chemical_list: D005782:Gels; D020574:Proto-Oncogene Proteins c-sis; D000077214:Becaplermin