Economic outcomes among Medicare patients receiving bioengineered cellular technologies for treatment of diabetic foot ulcers

Journal of Medical Economics
J Bradford RiceNathan B Parsons

Abstract

To assess the real-world medical services utilization and associated costs of Medicare patients with diabetic foot ulcers (DFUs) treated with Apligraf (bioengineered living cellular construct (BLCC)) or Dermagraft (human fibroblast-derived dermal substitute (HFDS)) compared with those receiving conventional care (CC). DFU patients were selected from Medicare de-identified administrative claims using ICD-9-CM codes. The analysis followed an 'intent-to-treat' design, with cohorts assigned based on use of (1) BLCC, (2) HFDS, or (3) CC (i.e., ≥1 claim for a DFU-related treatment procedure or podiatrist visit and no evidence of skin substitute use) for treatment of DFU in 2006-2012. Propensity score models were used to separately match BLCC and HFDS patients to CC patients with similar baseline demographics, wound severity, and physician experience measures. Medical resource use, lower-limb amputation rates, and total healthcare costs (2012 USD; from payer perspective) during the 18 months following treatment initiation were compared among the resulting matched samples. Data for 502 matched BLCC-CC patient pairs and 222 matched HFDS-CC patient pairs were analyzed. Increased costs associated with outpatient service utilization relati...Continue Reading

References

May 1, 1990·Diabetes Care·R E PecoraroE M Burgess
Mar 31, 1999·Diabetes Care·S D RamseyE H Wagner
May 27, 2003·Diabetes Care·William A MarstonUNKNOWN Dermagraft Diabetic Foot Ulcer Study Group
Nov 5, 2003·PharmacoEconomics·W Ken RedekopZoltan Kalo
Jan 13, 2005·JAMA : the Journal of the American Medical Association·Nalini SinghBenjamin A Lipsky
Nov 15, 2005·Wound Repair and Regeneration : Official Publication of the Wound Healing Society [and] the European Tissue Repair Society·David J MargolisJesse A Berlin
May 30, 2006·Diabetes Care·Lawrence A LaveryBenjamin A Lipsky
Feb 7, 2007·The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons·Robert G FrykbergUNKNOWN American College of Foot and Ankle Surgeons
Dec 25, 2007·International Wound Journal·David G ArmstrongJeffery M Robbins
Nov 5, 2013·Diabetes Care·J Bradford RiceNathan B Parsons
Mar 15, 2014·Journal of Medical Economics·J Bradford RiceNathan Parsons

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Citations

Oct 21, 2016·Tissue Engineering. Part B, Reviews·Vincent RonfardYves Bayon
Aug 2, 2017·Wound Repair and Regeneration : Official Publication of the Wound Healing Society [and] the European Tissue Repair Society·Marissa J Carter
Mar 6, 2019·Journal of Wound Care·Leanne AtkinWilliam Tettelbach
Oct 21, 2016·Physiological Genomics·Aksone NouvongHilary A Coller
Nov 7, 2019·Journal of Comparative Effectiveness Research·Thomas E SerenaMichael L Sabolinski

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