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Cost-Effectiveness of Becaplermin Gel on Diabetic Foot Ulcer Healing

Changes in Wound Surface Area

Curtis R. Waycaster Smith & Nephew Inc, Fort Worth, TX.
Department of Pharmacotherapy, University of North Texas Health Sciences Center, Fort Worth, TX.

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Adrienne M. Gilligan Smith & Nephew Inc, Fort Worth, TX.
Department of Pharmacotherapy, University of North Texas Health Sciences Center, Fort Worth, TX.

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Travis A. Motley University of North Texas Health Sciences Center, Bone and Joint Institute, Fort Worth, TX.

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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.

Corresponding author: Curtis R. Waycaster, PhD, Smith & Nephew Inc, 3909 Hulen Street, Fort Worth, TX 76107. (E-mail: Curtis.Waycaster@smith-nephew.com)