OBJECTIVES: To assess the cost-effectiveness of using intralesional injection of recombinant human epidermal growth factor (rhEGF) for the treatment of severe non-healing diabetic foot ulcers (DFU) in highly-specialized inpatient department in Russian setting. METHODS: We developed a cost-effectiveness model based on hypothesis that use of intralesional injection of rhEGF in addition to standard treatment of severe DFU (Wagner grade 3-4) would reduce the rate of amputations and related increased mortality in population of amputated DFU patients. For model inputs we used published data on the rates of amputation from retrospective study of intralesional injection of rhEGF and survival rates for patients with DFU with and without major amputations. Cost data was derived from the Russian retrospective study of real practice of inpatient treatment of severe DFU and reimbursement rates in Russian compulsory medical insurance system, cost of rhEGF treatment was provided by the manufacturer. Based on the model outputs we calculated incremental cost-effectiveness ratio (ICER) as the difference in costs to the difference in years lived during the 5-year period of observation by two cohorts of patients treated with only standard methods and with addition of rhEGF. RESULTS: The use of rhEGF intralesional injection treatment may prevent 52 amputations and save 29.54 years of life in a cohort of 100 patients with severe DFU during subsequent 5-year period of observation. The ICER for rhEGF is estimated at EURO 27,200 per life year saved and does not exceed the acceptable threshold of three GDP per capita as recommended by WHO. The sensitivity analysis demonstrated that the results are most sensitive  to the cost of rhEGF. CONCLUSIONS: The model has demonstrated the acceptability of adoption of intralesional injection of rhEGF in addition to standard treatment for DFU in highly specialized inpatient departments.