{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T19:34:00Z","timestamp":1780083240495,"version":"3.54.0"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T00:00:00Z","timestamp":1617753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The aim of this study was to estimate the cost\u2010effectiveness of using dehydrated human amnion\/chorion membrane (dHACM) allografts (Epifix) as an adjunct to standard care, compared with standard care alone, to manage non\u2010healing diabetic foot ulcers (DFUs) in secondary care in the United Kingdom, from the perspective of the National Health Service (NHS). A Markov model was constructed to simulate the management of diabetic lower extremity ulcers over a period of 1\u2009year. The model was used to estimate the cost\u2010effectiveness of using adjunctive dHACM, compared with standard care alone, to treat non\u2010healing DFUs in the United Kingdom, in terms of the incremental cost per quality\u2010adjusted life year (QALY) gained at 2019\/2020 prices. The study estimated that at 12\u2009months after the start of treatment, use of adjunctive dHACM instead of standard care alone is expected to lead to a 90% increase in the probability of healing, a 34% reduction in the probability of wound infection, a 57% reduction in the probability of wound recurrence, a 6% increase in the probability of avoiding an amputation, and 8% improvement in the number of QALYs. Additionally, if \u00a34062 is spent on dHACM allografts per ulcer, then adjunctive use of dHACM instead of standard care alone is expected to lead to an incremental cost per QALY gain of \u00a320\u2009000. However, if the amount spent on dHACM allografts was \u2264\u00a33250 per ulcer, the 12\u2010month cost of managing an ulcer treated with adjunctive dHACM would break\u2010even with that of DFUs treated with standard care, and it would have a 0.95 probability of being cost\u2010effective at the \u00a320\u2009000 per QALY threshold. In conclusion, within the study's limitations, and within a certain price range, adjunctive dHACM allografts afford the NHS a cost\u2010effective intervention for the treatment of non\u2010healing DFUs within secondary care among adult patients with type 1 or 2 diabetes mellitus in the United Kingdom.<\/jats:p>","DOI":"10.1111\/iwj.13591","type":"journal-article","created":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T23:22:26Z","timestamp":1617837746000},"page":"889-901","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Potential cost\u2010effectiveness of using adjunctive dehydrated human amnion\/chorion membrane allograft in the management of non\u2010healing diabetic foot ulcers in the United Kingdom"],"prefix":"10.1111","volume":"18","author":[{"given":"Julian F.","family":"Guest","sequence":"first","affiliation":[{"name":"Health Economics and Outcomes Research Catalyst Consultants  Poole UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leanne","family":"Atkin","sequence":"additional","affiliation":[{"name":"Vascular Surgery Mid Yorkshire Hospitals NHS Trust  Wakefield UK"},{"name":"University of Huddersfield  Huddersfield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Aitkins","sequence":"additional","affiliation":[{"name":"Diabetes Care Centre South Tees Hospitals NHS Foundation Trust  Middlesbrough UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-159-8-201310150-00006"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2013.07.048"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12816"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-020-00383-2"},{"key":"e_1_2_8_7_1","unstructured":"National Institute for Health and Care Excellence (NICE).Diabetic Foot Problems: Prevention and Management. 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