ORIGINAL RESEARCH article
Front. Public Health
Sec. Health Economics
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1625252
Cost-Utility Analysis of a Polylactic Acid Matrix versus a Collagen Dressing for the Closure of Diabetic Foot Ulcers
Provisionally accepted
Elaheh Khorasani1Aashita Batra2
Robert Bartlett3Stephen Bergquist4Brock A Liden5
Karla Rangel-Berridi1*- 1McGill University Health Centre, Montreal, Canada
- 2Independent Scientist, Boston, United States
- 3Cutis Care, Boca Raton, United States
- 4Jackson Clinic, Jackson, United States
- 5WAFL, Circleville, United States
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Background. Diabetic foot ulcers (DFUs) are a common and serious complication of diabetes, often requiring the use of advanced care products, which may have high upfront costs. With the hypothesis that this approach leads to faster healing, reduced costs, and better quality-adjusted life years (QALY), this study evaluates the economic outcomes, including cost-effectiveness and cost-benefit, of an alloplastic polylactic acid (PLA) dermal matrix and compares it to collagen dressings in managing DFUs. Methods. This cost-utility analysis was based on a randomized controlled trial involving patients with DFUs treated with either PLA matrices or collagen dressings, alongside standard wound care. Data on wound healing, cost of care, and QALY were collected over the whole duration of the trial (31-week period). We conducted a cost-benefit analysis by quantifying the monetary impact of reduced time-to-heal and avoided healthcare utilization. Additionally, we performed a cost-utility analysis using QALYs to capture patient-centered benefits. Results. At 12 weeks, 90% of the PLA group achieved wound closure compared to 30% in the collagen group, with PLA matrices reducing healing time by 44%. The cumulative cost of treatment for PLA was significantly lower, averaging $2,928 compared to $5,542 for collagen dressings (p <0.001). Sensitivity analyses confirmed the cost-effectiveness of PLA even when home healthcare costs were excluded. Cost-benefit analysis also demonstrated higher QALY in the PLA treated group. Conclusion. PLA dermal matrices provide a cost-effective alternative to collagen dressings, promoting faster wound closure, improved quality of life, and reduced healthcare costs. These results support the adoption of PLA as a preferred treatment for DFUs.
Keywords: Diabetic foot ulcer, polylactic acid matrix, Cost-Effectiveness, randomized controlledtrial, Quality-Adjusted Life Years, economic burden
Received: 08 May 2025; Accepted: 19 Sep 2025.
Copyright: © 2025 Khorasani, Batra, Bartlett, Bergquist, Liden and Rangel-Berridi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Karla Rangel-Berridi, jtws.usa@gmail.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.