OBJECTIVES: Current National Institute of Health and Care Excellence (NICE) guidance does not indicate a preferred dressing for patients with Diabetic Foot Ulcer (DFU). UrgoStart has recently been shown as superior to a neutral dressing in the double blind randomised controlled Explorer trial. This study examined the cost-effectiveness of UrgoStart compared with a neutral dressing for DFU patients.

METHODS: A Markov-model was designed with seven health states: open, closed, and complicated (pre and post amputation), and deceased. Complicated wounds can cause an amputation event, moving a patient to the post-amputation block. The model took the perspective of the National Health Service (NHS) in the United Kingdom, with a cohort of 1000 patients and base-case time horizon of 1 year. The Explorer trial informed transition probabilities and health-state utility scores; there were no statistically significant differences between the characteristics of the treatment arms at baseline. Both deterministic and probabilistic sensitivity analyses were performed.

RESULTS: UrgoStart was the dominant treatment strategy in terms of cost-effectiveness, with a cost saving of £666.51 and a 0.022 gain in quality-adjusted-life years, per patient. Using UrgoStart leads to more wounds healed at 52 weeks than a neutral dressing, 653 and 473 respectively at a cost of £4879.84 per healed wound for UrgoStart compared with £8136.19 for a neutral dressing. The use of UrgoStart also avoided 19 amputations over a year. Sensitivity analysis showed UrgoStart as cost saving, even when a comparator was set at £0. Across 1000 runs of the model, UrgoStart was dominant every time.

CONCLUSIONS: This analysis showed UrgoStart to be a cost-effective treatment option, with benefits to the patient and the NHS. Primary cost drivers such as community nurse visits and hospital admissions; can be reduced significantly with faster healing. UrgoStart should be considered as a treatment for all patients with a DFU.