OBJECTIVES: The primary objective of this study was to estimate the cost effectiveness of treating diabetic foot ulcers with ANGIPARS™ plus good wound care (GWC) compared with GWC alone in Iranian healthcare settings. A secondary objective was to analyse the effect of different treatment practices on the economics of caring for diabetic foot ulcers. METHODS: A 6-month Markov computer simulation model was used to assess the cost effectiveness in Iran of treating diabetic foot ulcers with ANGIPARS™  plus GWC versus GWC alone. Transition probabilities were taken from a prospective study of 20 patients and ANGIPARS™ efficacy was based on 20-week healing rates in a recent meta-analysis of clinical trials involving 50 patients. Country-specific treatment cost data were collected in collaboration with local economic consultations and combined with the disease model to estimate the incremental cost per ulcer-free month gained. The model was then run using hypothetical low- and high-intensity resource usage profiles to investigate the economics of caring for diabetic foot ulcers. RESULTS: Over the course of 6-month, individuals who received ANGIPARS™  plus GWC were, on average, predicted to spend an additional 0.81 months (24% longer) free of ulcers and to experience a 9% lower risk of undergoing a lower extremity amputation than individuals who received GWC alone. Consequently, ANGIPARS™  plus GWC was estimated to be net cost saving in Iran. CONCLUSIONS: ANGIPARS™  may be a cost-effective treatment for neuropathic diabetic foot ulcers in a wide range of Iranian settings.