Ghatnekar O, Willis M, Persson U
Swedish Institute for Health Economics, Lund, Sweden.
J Wound Care. 2002 Feb;11(2):70-4. doi: 10.12968/jowc.2002.11.2.26675.
This study aimed to estimate the cost-effectiveness of treating non-superficial diabetic foot ulcers with Promogran plus good wound care (GWC) compared with GWC alone in four European countries (France, Germany, Switzerland and UK).
An existing Markov-based health economic model of non-superficial diabetic foot ulcers was adapted to incorporate the relative efficacy of Promogran compared with GWC alone as demonstrated in a randomised controlled trial. Treatment with Promogran was modelled for a maximum of three months. Country-specific treatment costs were used to estimate the incremental cost per ulcer-free day gained over 12 months. Some parameter assumptions were changed to assess the sensitivity of the results.
Within the first three months of treatment, 26% of ulcers in the Promogran cohort healed compared with 20.7% in the GWC cohort. Over the 12 months, the average number of months spent in the healed state was 3.41 (GWC) and 3.75 (Promogran). Promogran treatment was found to be cost-saving in all four countries, using year 2000 Euro values.
Promogran with GWC may be cost-effective, perhaps even cost-saving, under a wide variety of assumptions for the treatment of neuropathic foot ulcers.
This study was funded by Ethicon Gmbh (Johnson and Johnson), Germany.
本研究旨在评估在四个欧洲国家（法国、德国、瑞士和英国），与单纯的良好伤口护理（GWC）相比，使用普朗格朗（Promogran）联合GWC治疗非浅表性糖尿病足溃疡的成本效益。
对现有的基于马尔可夫模型的非浅表性糖尿病足溃疡健康经济模型进行调整，纳入一项随机对照试验中所证明的普朗格朗相较于单纯GWC的相对疗效。对普朗格朗治疗建模最长为三个月。使用各国特定的治疗成本来估计在12个月内每获得一个无溃疡日的增量成本。改变一些参数假设以评估结果的敏感性。
在治疗的前三个月内，普朗格朗组中26%的溃疡愈合，而GWC组为20.7%。在12个月期间，处于愈合状态的平均月数在GWC组为3.41个月，在普朗格朗组为3.75个月。使用2000年欧元价值计算，发现在所有四个国家中普朗格朗治疗均具有成本节约效益。
在多种假设条件下，普朗格朗联合GWC治疗神经性足溃疡可能具有成本效益，甚至可能节约成本。
本研究由德国的Ethicon Gmbh（强生公司）资助。
