OBJECTIVES : Recent research suggests that the Medicare spending on chronic wounds such as venous leg ulcers (VLU) or diabetic foot ulcers (DFU) is significant ranging from $28.1 to $96.8 billion. Chronic wounds are commonly treated with various skin replacement products such as cryopreserved bioactive human split-thickness skin allograft (CBHSA), bioengineered living cellular construct (BLCC), or a cryopreserved human fibroblast–derived dermal substitute (CHDS). The current analysis examined differences in the real-world healthcare costs of Medicare patients treated with either CBHSA, BLCC, or CHDS for VLUs or DFUs.

METHODS : Medicare claims was used to identify VLU and DFU patients 18 years based on the first application of either CBHSA, BLCC, or CHDS (index date) from 01/01/2005 to 12/31/2014. All patients had a wound size of 20 cm² and at least 60 days of continuous coverage from index date. All-cause healthcare costs were examined from the index date to 60, 90, and 180 days as well as 1- and 2-year windows.

RESULTS : A total of 6,011 patients were identified (CBHSA n=364; BLCC n=4667; CHDS n=980). Cohorts were matched based on age, gender and comorbidity. At 60, 90, and 180 days, costs for the CBHSA cohort ($9,002; $12,723; $23,437) were significantly lower than the CHDS cohort ($14,389; $19,555; $28,155). The only statistical differences between CBHSA and BLCC cohorts was at 60 days where CBHSA was significantly lower ($8,598) than BLCC ($10,438). Across all time windows costs were significantly higher in the CHDS cohort relative to the BLCC patients.

CONCLUSIONS : The total Medicare costs for CBHSA patients were, on average, 30% lower the CHDS patients over the first 180 days and 18% lower over the first 60 days of treatment than patients treated with a BLCC.