OBJECTIVES: To assess cost-effectiveness of a sucrose octasulfate dressing (SOD, UrgoStart) versus a control dressing (CD, UrgoTul) on wound closure in patient with venous leg ulcers (VLU) and neuroischaemic diabetic foot ulcers (NDFU) in the Czech Republic.

METHODS: Based on randomised double-blind controlled trials (RCT: EXPLORER, CHALLENGE), we developed a one-year decision-tree model using TreeAge Pro. Depending on response to treatment, the model structure consists of two mutually exclusive health states: “treatment success” and “treatment failure”. If treatment fails, the 2^nd line of treatment (compression wrap therapy) is started. The 2^nd line of treatment can be accompanied either by mild adverse events (AE), severe AE (requiring hospitalization) or without AE. The model structure reflects the patient journey through the Czech healthcare system. Transition probabilities between health states were provided by RCTs, utilities by systematic literature review, costs and healthcare structure by reimbursement tariffs and expert opinion. Two parallel models with the same structure but different inputs were run for each kind of wound (VLU, NDFU) using an implicit willingness-to-pay (WTP) threshold of €47,000 per quality-adjusted life year (QALY). Sensitivity analyses were used to explore the impact of variations.

RESULTS: From a health care payer perspective, SOD for NDFU and VLU were dominant. SOD brought 0.03 (0.67 vs. 0.64) and 0.05 (0.53 vs. 0.48) incremental QALY, respectively. Incremental costs were €-5 (€1,518 vs. €1,523) and €-143 (€925 vs. €783), respectively. Sensitivity analysis showed that even with the SOD price ten-time higher than CD, the incremental cost-effectiveness ratio stayed well below WTP threshold (€21,777 for NDFU and €2,888 for VLU).

CONCLUSIONS: The results of the models indicate that SOD is highly cost-effective dressing for NDFU/VLU in the Czech Republic. Sensitivity analyses confirmed the robustness of the base-case results with all one-way changes and scenarios deeply below WTP.