{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T21:43:07Z","timestamp":1791495787037,"version":"4.3.4"},"reference-count":57,"publisher":"Mark Allen Group","issue":"Sup3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wound Care"],"published-print":{"date-parts":[[2024,3,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate the cost-effectiveness of dehydrated human amnion\/chorion membrane (DHACM) in Medicare enrolees who developed a venous leg ulcer (VLU).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>This economic evaluation used a four-state Markov model to simulate the disease progression of VLUs for patients receiving advanced treatment (AT) with DHACM or no advanced treatment (NAT) over a three-year time horizon from a US Medicare perspective. DHACM treatments were assessed when following parameters for use (FPFU), whereby applications were initiated 30\u201345 days after the initial VLU diagnosis claim, and reapplications occurred on a weekly to biweekly basis until completion of the treatment episode. The cohort was modelled on the claims of 530,220 Medicare enrolees who developed a VLU between 2015\u20132019. Direct medical costs, quality-adjusted life years (QALYs), and the net monetary benefit (NMB) at a willingness-to-pay threshold of $100,000\/QALY were applied. Univariate and probabilistic sensitivity analyses (PSA) were performed to test the uncertainty of model results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>DHACM applied FPFU dominated NAT, yielding a lower per-patient cost of $170 and an increase of 0.010 QALYs over three years. The resulting NMB was $1178 per patient in favour of DHACM FPFU over the same time horizon. The rate of VLU recurrence had a notable impact on model uncertainty. In the PSA, DHACM FPFU was cost-effective in 63.01% of simulations at the $100,000\/QALY threshold.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In this analysis, DHACM FPFU was the dominant strategy compared to NAT, as it was cost-saving and generated a greater number of QALYs over three years from the US Medicare perspective. A companion VLU Medicare outcomes analysis revealed that patients who received AT with a cellular, acellular and matrix-like product (CAMP) compared to patients who received NAT had the best outcomes. Given the added clinical benefits to patients at lower cost, providers should recommend DHACM FPFU to patients with VLU who qualify. Decision-makers for public insurers (e.g., Medicare and Medicaid) and commercial payers should establish preferential formulary placement for reimbursement of DHACM to reduce budget impact and improve the long-term health of their patient populations dealing with these chronic wounds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Declaration of interest:<\/jats:title>\n                    <jats:p>Support for this analysis was provided by MiMedx Group, Inc., US. JLD, and RAF are employees of MiMedx Group, Inc. WHT, BH, PS, BGC and WVP were consultants to MiMedx Group, Inc. VD, AO, MRK, JAN, NW and GAM served on the MiMedx Group, Inc. Advisory Board. MRK and JAN served on a speaker's bureau. WVP declares personal fees and equity holdings from Stage Analytics, US.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.12968\/jowc.2024.33.sup3.s24","type":"journal-article","created":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T12:05:17Z","timestamp":1709899517000},"page":"S24-S38","source":"Crossref","is-referenced-by-count":21,"title":["Dehydrated human amnion\/chorion membrane to treat venous leg ulcers: a cost-effectiveness analysis"],"prefix":"10.12968","volume":"33","author":[{"given":"William H","family":"Tettelbach","sequence":"first","affiliation":[{"name":"RestorixHealth, Los Angeles, CA, US"},{"name":"College of Podiatric Medicine, Western University of Health Sciences, US"},{"name":"Duke University School of Medicine, Department of Anesthesiology, US"},{"name":"American Professional Wound Care Association, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vickie","family":"Driver","sequence":"additional","affiliation":[{"name":"Wound Care and Hyperbaric Centers at INOVA Healthcare, US"},{"name":"Wound Care Collaborative Community, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisha","family":"Oropallo","sequence":"additional","affiliation":[{"name":"Comprehensive Wound Healing Center, US"},{"name":"Hyperbarics at Northwell Health, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha R","family":"Kelso","sequence":"additional","affiliation":[{"name":"Wound Care Plus, LLC., MO, 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":"Naz","family":"Wahab","sequence":"additional","affiliation":[{"name":"Wound Care Experts, NV, US"},{"name":"HCA Mountain View Hospital, US"},{"name":"Roseman University College of Medicine, US"},{"name":"Common Spirit Dignity Hospitals, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie L De","family":"Jong","sequence":"additional","affiliation":[{"name":"MiMedx Group, Inc., GA, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Hubbs","sequence":"additional","affiliation":[{"name":"MiMedx Group, Inc., GA, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R Allyn","family":"Forsyth","sequence":"additional","affiliation":[{"name":"MiMedx Group, Inc., GA, US"},{"name":"Department of Biology, San Diego State University, CA, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory A","family":"Magee","sequence":"additional","affiliation":[{"name":"Keck School of Medicine of USC, Los Angeles, CA, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Steel","sequence":"additional","affiliation":[{"name":"Stage Analytics, Suwanee, GA, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin G","family":"Cohen","sequence":"additional","affiliation":[{"name":"Stage Analytics, Suwanee, GA, US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William V","family":"Padula","sequence":"additional","affiliation":[{"name":"Stage Analytics, Suwanee, GA, US"},{"name":"Department of Pharmaceutical & Health Economics, Mann School of Pharmacy & Pharmaceutical Sciences, University of Southern California, Los Angeles, CA, US"},{"name":"The Leonard D. 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