Health resource utilization and cost analysis in Medicare beneficiaries with chronic wounds: outcomes with porcine placental extracellular matrix versus standard of care and other advanced treatments

Aim: To compare the healthcare resource utilization, spending and clinical outcomes associated with porcine placental extracellular matrix (PPECM [InnovaMatrix ® AC, Convatec Triad Life Sciences, LLC, TN, USA]) versus standard of care (SOC) and other advanced treatments (AT) among Medicare Fee-For-Service beneficiaries with diabetic foot ulcers (DFU) or venous leg ulcers (VLU). Materials & methods: A retrospective cohort study was conducted using 100% Medicare Parts A and B administrative claims from October 2021 through December 2024. Treatment episodes for DFU and VLU were identified and categorized as PPECM plus SOC, SOC alone or AT plus SOC. Patients were followed for 6 months after the end of each treatment episode. Outcomes included post-episode healthcare utilization by site of care, per-patient-per-month spending, wound-related complications and amputations. Results: The final study sample included 109,786 eligible DFU patients (117,633 episodes of care; PPECM 0.2%, SOC 95.0%, AT 4.8%) and 53,624 eligible VLU patients (56,498 episodes of care; PPECM 0.1%, SOC 95.5%, AT 4.4%). In DFU, PPECM was associated with significantly lower post-episode utilization in most sites of care compared with SOC, and fewer wound complications including amputations compared with AT. Although total post-episode costs were higher for PPECM than SOC and AT in DFU, PPECM had lower overall cost at specific types of care sites. In VLU, PPECM was associated with significantly fewer visits across most sites of care compared with AT and SOC. PPECM-treated VLU episodes had significantly lower total costs than both SOC and AT. Rates of wound complications and amputations were similar across treatment groups in VLU. Conclusion: Treatment with PPECM demonstrated lower overall post-episode costs compared with SOC and other AT while maintaining safety outcomes, particularly in VLU, suggesting potential value in chronic wound management.