Pharmacoeconomic analysis of epidermal growth factor (HeberprotP ®) for the treatment of diabetic foot ulcers

Abstract

The epidermal growth factor (EGF; Heberprot?P® ) is the new treatment for deep persistent diabetic foot ulcers (Wagner grade 3–4). The effectiveness of EGF measured as the reduction of the time to complete granulation of tissue lesions was confirmed in randomised clinical trials, but the cost of this new treatment is high. Aim. To analyze the costs and outcomes of the use of EGF (Heberprot?P® ) for the treatment of DFU in high? ly specialized medical institutions. Material and methods. We tested the hypothesis that the use of Heberprot?P® in diabetic foot ulcers – DFU – (Wagner grade 3–4) would reduce the rate of amputations and increase survival at acceptable cost for the Russian healthcare system. We used the data from international published literature to construct mathematical model representing clinical outcomes in the cohort of patients treated with only standard methods or standard methods in combination with Heberport?P® . We calculated direct costs associated with both strategies of treatment taking into account the risk of amputation. Results. The use of Heberprot?P® may prevent 52 amputations and save 29.54 years of life in a cohort of 100 DFU patients (Wagner grade 3–4). The incremental costs of EGF treatment were RUR 1.170.000 per life year gained and did not exceed the accepted threshold of less than three times GDP per capita. Conclusion. Mathematic modelling demonstrated the feasibility of introduction of EGF in combination with standard treatment for DFU in highly specialized medical institutions. Key words: epidermal growth factor, diabetic foot ulcers, risk of amputation, Heberprot?P® .