Skip to main content

Table 3 Overview of health economic evaluations of cellular wound care products

From: Systematic review of economic evaluations of human cell-derived wound care products for the treatment of venous leg and diabetic foot ulcers

Wound care product Source: author, country, year Type of ulcers Interventions Perspective Type of econ. eval. Primary outcome measures/source of effectiveness evidence Cost-effectiveness results (base case) Sources of funding Evidence
Skin Substitutes         
Apligraf® a AÉTMIS, CA, 2000 Venous leg (1) Compression alone
(2) Compression plus Apligraf® simultaneously
(3) Compression plus Apligraf® for hard-to-heal ulcers
Societal/health care system CEAg Number of ulcer days averted/Falanga et al. 1998 The incremental cost per ulcer day averted of compression and Apligraf® simultaneously used vs. compression alone was Can $26 (US $22)d, and Can $22 (US $18)d when Apligraf® was restricted to hard-to-heal ulcers. The price year was not reported. Not stated Limitedh, i
  Harding et al., UK, 2000 Venous leg (1) Saline gauze
(2) Granuflex® e
(3) Apligraf®
Health care payer CEAg 12-week healing rate/literature review The cost per wound healed was £541 (US $828)d for saline gauze, £341 (US $522)d for Granuflex®, and £6,741 (US $10,323)d for Apligraf. The price year was 1999. ConvaTec  
  Kerstein et al., US, 2001 Venous leg (1) Impregnated gauze
(2) DuoDERM® f
(3) Apligraf®
Health care payer CEAg Number of persons healed/not healed after 12 weeks/literature review The cost per patient healed was US $2,939 for impregnated gauze, US $1,873 for DuoDERM®, and US $15,053 for Apligraf®. The price year was 2000. ConvaTec  
  Meaume/Gemmen, FR, 2002 Venous leg (1) Saline gauze
(2) DuoDERM® f
(3) Apligraf®
Health care payer CEAg Number of persons healed/not healed after 12 weeks/literature review The cost per patient healed was £1,722 (US $1,832)d for saline gauze, £1,018 (US $1,083)d for DuoDERM®, and £ 15,920 (US $16,936)d for Apligraf®. The price year was 1999/2000. ConvaTec  
  Steinberg et al. US, 2002 Diabetic foot (1) Saline-moistened gauze alone
(2) Saline-moistened gauze plus Apligraf®
Health care payer CEA Number of ulcer-free months gained, number of amputations or resections avoided/Veves et al. 2001 The incremental cost of Apligraf® vs. control per ulcer-free month gained was US $6,683, and US $86,226 when amputations or resections avoided were considered as benefit measures. The price year was 2000. Novartis  
Dermagraft® b Segal/John, AU, 2002 Diabetic foot (1) Convent. management alone
(2) Convent. management plus Dermagraft®
Health care payer CEAg Number of healed weeks/Naughton et al. 1997 The incremental cost per additional healed week of Dermagraft® vs. control was A $383 (US $292)d. The price year was 2000. Smith + Nephew Pty. Ltd. Limitedh, i, j
Growth Factors         
Becaplermin (Regranex® c) Ghatnekar et al., UK, 2000 Diabetic foot (1) Good wound care (GWC) alone
(2) GWC plus becaplermin
Health care system CEAg Number of ulcer days averted/Smiell et al. 1999 Becaplermin plus GWC was found to be cost saving. The price year was not reported. Not clearly stated Good
  Ghatnekar et al., CH/FR/SE/UK, 2001 Diabetic foot (1) GWC alone
(2) GWC plus becaplermin
Health care system CEAg Number of ulcer-free months gained/Smiell et al. 1999 Becaplermin plus GWC was found to be cost saving in Sweden, Switzerland and the UK. The incremental cost per ulcer-free month gained of becaplermin over GWC alone was US $19 in France. The price year was 1999. R.W. Johnson Pharmaceutical Research Institute  
  Kantor/Margolis, US, 2001 Diabetic foot (1) Standard care at a primary care setting (SC)
(2) Standard treatment at a specialised wound care centre (WCC)
(3) Treatment with platelet releasate at a wound care centre (PR)
(4) Becaplermin
Health care payer CEAg Percentage of ulcers healed after 20 weeks/Wieman 1998 The incremental cost per additional 1% of ulcers healed (most expensive vs. least expensive) was US $36.59 (SC vs. becaplermin), and US $70.86 (becaplermin vs. WCC). Becaplermin dominated PR. The price year was 1999. Curative Health Services, National Institutes of Health Geriatric Epidemiology  
  Persson et al. SE, 2000 Diabetic foot (1) GWC alone
(2) GWC plus becaplermin
Health care system CEAg Number of ulcer-months avoided/Smiell et al. 1999 Becaplermin plus GWC was found to be cost saving. The price year was 1999. R.W. Johnson Pharmaceutical Research Institute  
  Sibbald et al., CA, 2003 Diabetic foot (1) Best clinical care (BCC) alone
(2) BCC plus becaplermin
Societal CEAg Number of ulcer days averted/Wieman et al. 1998 The ICER was Can $6 (US $5)d. The costs were estimated in 1998 and updated to 2002 costs using the Canadian Consumer Price Index for Personal and Health Care. Janssen-Ortho Inc.  
  1. a Apligraf® is a registered trademark of Novartis. b Dermagraft® is a registered trademark of Advanced BioHealing, Inc. c Regranex® is a registered trademark of Systagenix Wound Management, Inc. d US $ converted by purchasing-power parity rates of the publication year. e Also known as DuoDERM® in France and in the US. f DuoDERM® is a registered trademark of Convatec. gCost-effectiveness model. h Inappropriate treatment of uncertainty.i Small sample sizes.j Only average cost-effectiveness ratios. AÉTMIS: Agence d'évaluation des technologies et des modes d'intervention en santé; AU: Australia; BCC: best clinical care; CA: Canada; CEA: cost-effectiveness-analysis; CH: Switzerland; DE: Germany; FR: France; GWC: good wound care; ICER: incremental cost-effectiveness ratio; PR: platelet releasate; SE: Sweden; UK: United Kingdom; US: United States.