OBJECTIVES: Platelet-rich plasma (PRP) has shown certain effectiveness applied in diabetic foot ulcers but there is uncertainty about its efficiency.

METHODS: We performed an economic evaluation of PRP treatment versus standard treatment in patients with diabetic foot ulcer without severe ischaemia, using a Markov model with a 5-year time horizon and Spanish health-care perspective. Treatment costs and outcomes, complications (infections and amputations), recurrences and follow-up (cured and amputated patients) were modeled. Treatment effectiveness was estimated through own meta-analysis, the transition probabilities and utility weights were cited from literature, and the resources were valued with Spanish unit costs, expressed in Euros for 2017. A 3% discount was used for costs and utilities.

RESULTS: For the base case, where the PRP price was set at 174€/session, PRP treatment was 597€ more expensive and provided 0.0143 quality-adjusted life years (QALYs) gained per patient. The incremental cost-effectiveness ratio (ICER) was estimated at 41,800 €/QALY. The sensitivity analysis revealed that the results are sensitive to effectiveness values and the unit price of the PRP. With the price of the PRP falling to 124€, the ICER would fall to 3,550€/QALY, resulting highly cost-effective.

CONCLUSIONS: PRP treatment is more effective and more expensive than standard treatment, currently with a cost-effectiveness ratio above the threshold of acceptability in Spain. This result depends to a large extent on the unit price of the PRP, which is likely to fall over time, with more extensive use.