Cost-effectiveness of Platelet-Rich Plasma for Diabetic Foot Ulcer in Spain
- Pérez, Lidia-García 1234
- Serrano-Aguilar, Pedro 2345
- Aragón-Sánchez, Javier 6
- Trujillo-Martín, Mar 1234
- Iruzubieta-Barragan, Francisco J. 27
-
Linertová, Renata
1234
- del Pino-Sedeño, Tasmania 13
- Andia-Ortiz, Isabel 8
- 1 Canary Islands Foundation of Health Research (FIISC), Santa Cruz de Tenerife, Spain
- 2 Health Services and Chronic Diseases Research Network (REDISSEC), Barcelona, Spain
- 3 Spanish Network of Health Technology Assessment (RedETS), Spain
- 4 Center for Biomedical Research of the Canary Islands (CIBICAN), Santa Cruz de Tenerife, Spain
- 5 Canary Islands Health Service (SESCS), Santa Cruz de Tenerife, Spain
- 6 La Paloma Hospital, Las Palmas de Gran Canaria, Spain
- 7 La Rioja University, Logroño, Spain
- 8 University Hospital of Cruces, Barakaldo, Spain
ISSN: 1534-7346, 1552-6941
Año de publicación: 2020
Páginas: 153473462090323
Tipo: Artículo
Otras publicaciones en: The International Journal of Lower Extremity Wounds
Resumen
This study evaluated the cost-effectiveness of platelet-rich plasma (PRP) added to usual care versus usual care alone in elderly patients with chronic diabetic foot ulcer (DFU) from the Spanish health care system perpective. A 6-state Markov model with 3-month cycles was used to estimate costs and outcomes of wound healing and risk of recurrences, infections, and amputations over 5 years. Three treatment strategies were compared: ( a) usual care plus PRP obtained with a commercial kit, ( b) usual care plus PRP obtained manually, and ( c) usual care. Data on effectiveness were taken from a recent meta-analysis. Outcomes and costs were discounted at 3% and resources were valued in 2018 euro. Compared with usual care, the PRP treatment with the manual method was more effective and less costly (dominant option), whereas the PRP treatment with the commercial kit was more effective but also more costly, with the incremental ratio being above the cost-effectiveness threshold (€57 916 per quality-adjusted life year). These results are sensitive to the price of PRP kits (a 20% discount would make the PRP treatment a cost-effective option) and effectiveness data, due to the heterogeneity of primary studies. In conclusion, PRP treatment for DFUs could be considered a cost-effective or even cost-saving alternative in Spain, depending on the method of obtaining the PRP. Despite the dominance of the manual method, its general use is limited to hospitals and specialized centers, whereas PRP kits could be used in primary care settings, but their prices should be negotiated by health authorities.
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