Cost-effectiveness of three adjunct cellular/tissue-derived products used in the management of chronic XXXX .

@entity1 @entity93 @entity1066 @entity3179 @entity204
OBJECTIVES: Determine the cost-effectiveness of three topically applied cellular/tissue-derived products (CTPs) used as adjunct therapies to standard care in the management of @entity3179 ( @entity3179 ). METHODS: A three-state Markov model derived from the medical literature was developed to estimate the comparative cost-effectiveness of three CTPs in relation to VLU standard care. CTPs evaluated in the study included extracellular matrix (ECM), @entity1 skin equivalent (HSE), and living skin equivalent (LSE). The three Markov states included unhealed, healed, and @entity204 . A 1-year time horizon was used to determine the number of @entity1066 and the expected costs of therapies. The payer perspective was taken in the analysis and only the direct costs of care were considered. Sensitivity analyses were performed to gauge model parameter uncertainty. RESULTS: The expected costs for standard care, ECM, HSE, and LSE VLU therapy were  6,132,  6,732,  10,638, and  11,237, while the expected outcomes were 24, 31, 29, and 27 @entity1066 , respectively. ECM was economically dominant among the three CTPs. In the base case of ECM versus standard care, the incremental cost-effectiveness ratio for ECM therapy was  86 per @entity1066 -free week. Sensitivity analysis did not alter ECM dominance. Clinic visits and home health utilization exhibited the greatest influence on cost. CONCLUSIONS: ECM is the most cost-effective @entity93 when used in the management of @entity3179 as an adjunct to standard care. These findings suggest that VLU standard care therapy with ECM can yield potential cost savings and produce better outcomes than do other CTPs.
