Cost Impact of the Porcine Urinary Bladder Matrix in Patients With Diabetic Foot Ulcer in the United Kingdom
Author(s)
Oleg Borisenko, PhD, MD1, Marino Ciliberti, MD2, Lisa Da Deppo, MBA, MSc3.
1European Med Tech and IVD Reimbursement Consulting Ltd., Alicante, Spain, 2Rete Aziendale di Riparazione Tissutale ASL Napoli 3 Sud, Health Authority, Napoli, Italy, 3Market Access, Integra LifeSciences, Milano, Italy.
1European Med Tech and IVD Reimbursement Consulting Ltd., Alicante, Spain, 2Rete Aziendale di Riparazione Tissutale ASL Napoli 3 Sud, Health Authority, Napoli, Italy, 3Market Access, Integra LifeSciences, Milano, Italy.
OBJECTIVES: The objective was to determine the cost consequences of porcine urinary bladder matrix (Cytal, Integra Lifesciences) in addition to routine management (RM) compared with RM alone for the management of recalcitrant, neuropathdiabetic diabetic foot ulcers (DFUs) in the United Kingdom (UK) from the perspective of the healthcare payer.
METHODS: A decision-analytic model was developed. The model included patients with non-healing (for more than two months) DFUs, Grade I-A according to the University of Texas Wound Classification System, with a mean ulcer size of 12.85 cm2 and a mean ulcer age of 5.2 months. Clinical inputs were informed by the randomized controlled trial of Alvarez et al. 2017. Patients could experience wound healing (15.5 weeks in the wound matrix group and 23.3 weeks in the RM group) and recurrence of wound in one year (10% and 50%, respectively). Only direct medical costs were considered, including cost of surgical debridement, wound matrix, and cost of regular hospital and ambulatory care, including dressings and offloading devices. Unit costs were obtained from the NHS Reference Cost, published UK literature and market cost of wound matrix. Time horizon was 1.5 years, and the analysis was performed from the perspective of the UK healthcare payer.
RESULTS: The total cost of care was £4,747 in the group of wound matrix in comparison with £7,573 in the RM group (cost saving of £2,825 per patient). The cost of management of original wound was £4,348 and £5,576, and the cost of management of recurrent wound was £399 and £1,996 in the wound matrix and RM groups, respectively.
CONCLUSIONS: Cost analysis indicated that porcine urinary bladder matrix can reduce total cost of care for patients with difficult-to-heal diabetic foot ulcers in the UK. Cost savings are driven by faster healing of original wounds and a lower recurrence rate using urinary bladder matrix.
METHODS: A decision-analytic model was developed. The model included patients with non-healing (for more than two months) DFUs, Grade I-A according to the University of Texas Wound Classification System, with a mean ulcer size of 12.85 cm2 and a mean ulcer age of 5.2 months. Clinical inputs were informed by the randomized controlled trial of Alvarez et al. 2017. Patients could experience wound healing (15.5 weeks in the wound matrix group and 23.3 weeks in the RM group) and recurrence of wound in one year (10% and 50%, respectively). Only direct medical costs were considered, including cost of surgical debridement, wound matrix, and cost of regular hospital and ambulatory care, including dressings and offloading devices. Unit costs were obtained from the NHS Reference Cost, published UK literature and market cost of wound matrix. Time horizon was 1.5 years, and the analysis was performed from the perspective of the UK healthcare payer.
RESULTS: The total cost of care was £4,747 in the group of wound matrix in comparison with £7,573 in the RM group (cost saving of £2,825 per patient). The cost of management of original wound was £4,348 and £5,576, and the cost of management of recurrent wound was £399 and £1,996 in the wound matrix and RM groups, respectively.
CONCLUSIONS: Cost analysis indicated that porcine urinary bladder matrix can reduce total cost of care for patients with difficult-to-heal diabetic foot ulcers in the UK. Cost savings are driven by faster healing of original wounds and a lower recurrence rate using urinary bladder matrix.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
MT12
Topic
Economic Evaluation, Medical Technologies
Disease
Injury & Trauma, Neurological Disorders