{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T02:33:11Z","timestamp":1789612391506,"version":"build-2803163510"},"reference-count":24,"publisher":"Mark Allen Group","issue":"Sup2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wound Care"],"published-print":{"date-parts":[[2022,2,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate the cost-effectiveness and budget impact of using standard care (no advanced treatment, NAT) compared with an advanced treatment (AT), dehydrated human amnion\/chorion membrane (DHACM), when following parameters for use (FPFU) in treating lower extremity diabetic ulcers (LEDUs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>We analysed a retrospective cohort of Medicare patients (2015\u20132019) to generate four propensity-matched cohorts of LEDU episodes. Outcomes for DHACM and NAT, such as amputations, and healthcare utilisation were tracked from claims codes, analysed and used to build a hybrid economic model, combining a one-year decision tree and a four-year Markov model. The budget impact was evaluated in the difference in per member per month spending following completion of the decision tree. Likewise, the cost-effectiveness was analysed before and after the Markov model at a willingness to pay (WTP) threshold of $100,000 per quality adjusted life year (QALY). The analysis was conducted from the healthcare sector perspective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>There were 10,900,127 patients with a diagnosis of diabetes, of whom 1,213,614 had an LEDU. Propensity-matched Group 1 was generated from the 19,910 episodes that received AT. Only 9.2% of episodes were FPFU and DHACM was identified as the most widely used AT product among Medicare episodes. Propensity-matched Group 4 was limited by the 590 episodes that used DHACM FPFU. Episodes treated with DHACM FPFU had statistically fewer amputations and healthcare utilisation. In year one, DHACM FPFU provided an additional 0.013 QALYs, while saving $3,670 per patient. At a WTP of $100,000 per QALY, the five-year net monetary benefit was $5003.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The findings of this study showed that DHACM FPFU reduced costs and improved clinical benefits compared with NAT for LEDU Medicare patients. DHACM FPFU provided better clinical outcomes than NAT by reducing major amputations, ED visits, inpatient admissions and readmissions. These clinical gains were achieved at a lower cost, in years 1\u20135, and were likely to be cost-effective at any WTP threshold. Adoption of best practices identified in this retrospective analysis is expected to generate clinically significant decreases in amputations and hospital utilisation while saving money.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.12968\/jowc.2022.31.sup2.s10","type":"journal-article","created":{"date-parts":[[2022,2,12]],"date-time":"2022-02-12T02:28:56Z","timestamp":1644632936000},"page":"S10-S31","source":"Crossref","is-referenced-by-count":43,"title":["Cost-effectiveness of dehydrated human amnion\/chorion membrane allografts in lower extremity diabetic ulcer treatment"],"prefix":"10.12968","volume":"31","author":[{"given":"William H","family":"Tettelbach","sequence":"first","affiliation":[{"name":"MIMEDX Group, Inc., US"},{"name":"College of Podiatric Medicine, Western University of Health Sciences, US"},{"name":"Duke University School of Medicine, Department of Anesthesiology, US"},{"name":"Association for the Advancement of Wound Care"},{"name":"Western Peaks Specialty Hospital, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David G","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Southwestern Academic Limb Salvage Alliance (SALSA)"},{"name":"Keck School of Medicine, University of Southern California, Department of Surgery, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J","family":"Chang","sequence":"additional","affiliation":[{"name":"Redwood Orthopedic Surgery Associates, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie L De","family":"Jong","sequence":"additional","affiliation":[{"name":"MIMEDX Group, Inc., US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul M","family":"Glat","sequence":"additional","affiliation":[{"name":"Saint Christopher's Hospital, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey H","family":"Hsu","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Southern California, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha R","family":"Kelso","sequence":"additional","affiliation":[{"name":"Wound Care Plus, LLC, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey A","family":"Niezgoda","sequence":"additional","affiliation":[{"name":"AZH Wound & Vascular Centers, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan M","family":"Labovitz","sequence":"additional","affiliation":[{"name":"College of Podiatric Medicine, Western University of Health Sciences, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Hubbs","sequence":"additional","affiliation":[{"name":"MIMEDX Group, Inc., US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R Allyn","family":"Forsyth","sequence":"additional","affiliation":[{"name":"MIMEDX Group, Inc., US"},{"name":"Department of Biology, San Diego State University, San Diego, California, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin G","family":"Cohen","sequence":"additional","affiliation":[{"name":"Monument Analytics, Baltimore, MD, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie M","family":"Reid","sequence":"additional","affiliation":[{"name":"Monument Analytics, Baltimore, MD, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William V","family":"Padula","sequence":"additional","affiliation":[{"name":"Monument Analytics, Baltimore, MD, US"},{"name":"Department of Pharmaceutical & Health Economics, School of Pharmacy, University of Southern California, Los Angeles, CA, US"},{"name":"The Leonard D. 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