OBJECTIVES: Diabetic foot ulcer (DFU) is considered a non-solved medical need and its treatment is a challenge for physicians globally. Recombinant human epidermal growth factor (rhEGF) Heberprot-P^Ò is a new technology that promotes granulation and epithelialization in DFU. A complete economic evaluation of rhEGF as an adjuvant in patients with DFU was developed from the payer perspective.

METHODS

: A cost-effectiveness analysis with the use of rhEGF plus conventional therapy compared to conventional therapy in patients with Wagner’s grade 3 or 4 DFU (>1 cm) was developed with a time horizon of 1 year. A Markov model, with 3 transition states and weekly cycles was built, in order to calculate the number of patients with a complete healed ulcer (primary outcome) and avoided amputations (secondary outcome) with each alternative. The model was done with high quality evidence from a systematic review, considering the administration of rhEGF (75 mcg) 3 times per week for 8 weeks. The resource use for each state was included according to Clinical Guidelines and costs published by public health institutions. Deterministic and probabilistic sensitivity analysis were performed on the parameters that could generate uncertainty.

RESULTS

: rhEGF accomplished the healing of DFU in 72 patients (of every hundred), while conventional therapy healed 48 patients. The additional cost with the use of rhEGF was $11,264,090.88 MXN, resulting in an incremental cost-effectiveness ratio of $462,172.52 MXN, which means that rhEGF (additional to conventional therapy) is a cost-effective alternative. Also, the used of rhEGF showed that its treatment avoid 10 additional amputations in contrast to only conventional treatment. The sensitivity analysis revealed that the efficacy of rhEGF was the parameter that affected most the result.

CONCLUSIONS

: The use of hrGCE Heberprot-P^Òas an adjuvant in the treatment of patients with DFU is a cost-effective alternative that increases healing probability and reduces the probability of amputation.