Fish skin grafts* are a cost effective treatment option for diabetic foot ulcers

Standard treatment of chronic diabetic foot ulcers (DFU) is expensive and, for more than half of DFU patients, unsuccessful1. Health care policy decision makers should seek the most effective treatment options at the lowest cost, and cost-benefit analysis is one of the tools that can be used to this end. The objective of this retrospective comparative cohort study was to evaluate the cost effectiveness of fish skin graft* therapy compared with standard of care (SOC) on DFUs. Retrospective data on 59 DFUs treated with fish skin grafts* was used to calculate transition probabilities for a Markov model in which fish skin* treatment was compared with SOC. Cost was from the perspective of the payer, and the time horizon was set at 1 year. The model indicated that fish skin* treatment could result in lower costs ($11 210 vs. $15 075 per wound), more wounds healing (83.2% vs. 63.4%), fewer amputations (4.6% vs. 6.9%), and a higher quality of life (0.676 vs. 0.605 quality-adjusted life year [QALY]) than the SOC. A probabilistic sensitivity analysis, based on a Monte Carlo simulation, indicated that the fish skin graft* treatment (on DFUs) would be 93.6% likely to be cost effective for a willingness to pay at $100 000 per QALY and 71.4% likely to be cheaper than SOC. The results of this analysis suggest that including fish skin grafts* in the SOC for DFU treatment has the potential to reduce costs while improving patient outcomes. This work was published in the journal Wounds in October 2020.