The Cost Effectiveness of Apligraf(R) Treatment of Diabetic Foot Ulcers

Background: Diabetic foot ulcers (DFUs) present a treatment challenge and result in a large economic burden, requiring careful evaluation of the clinical efficacy and cost effectiveness of new treatment modalities. DFU clinical trials of the bio-engineered skin substitute Apligraf(R) (Novartis Pharma AG, Basel, Switzerland) have demonstrated improved clinical efficacy compared with good wound care (GWC) alone. Objective: To determine the economic impact and cost effectiveness of Apligraf(R) plus GWC compared with GWC alone in the treatment of DFUs. Study perspective: Societal. Methods: A Markov-based simulation model was created to compare the costs and effects of Apligraf(R) plus GWC to those of GWC alone over a 12-month period. The primary health states were Results: Costs in the first year of treatment were Conclusions: Treatment with Apligraf(R) plus GWC resulted in a 12% reduction in costs over the first year of treatment compared with GWC alone. The increased ulcer-free time coupled with a reduced risk of amputation to a large extent offset the initial costs of the product.