Remote Diabetic Foot Temperature Monitoring for Early Detection of Diabetic Foot Ulcers: A Cost-Effectiveness Analysis

Elizabeth Brooks,1 Megan Burns,1 Ran Ma,2 Henk Jan Scholten,2 Shawn Becker3 1TTi Health Research and Economics, Westminster, MD, USA; 2Siren Care, Inc, San Francisco, CA, USA; 3Silvercat Advisors, LLC, Burlingame, CA, USACorrespondence: Megan BurnsTTi Health Research and Economics, 1231 Tech Ct Suite 201, Westminster, MD, 21157, USAEmail meganalexburns@gmail.comBackground: Foot temperature monitoring for the prevention and early detection of diabetic foot ulcers (DFU) is evidence-based and recommended in clinical practice. However, easy-to-use remote monitoring tools have been lacking, thereby preventing widespread adoption.Objective: To evaluate the cost-effectiveness of remote foot temperature monitoring (RFTM) (Siren’s Neurofabric™ Diabetic socks) in addition to standard of care (SoC) versus SoC alone for early detection of DFU with diabetic neuropathy and a moderate to high risk of DFU.Methods: A payer perspective decision-tree analysis was conducted to compare expected DFU occurrence and subsequent amputation rates and costs between treatment strategies over one year. Inputs in the model were sourced from publicly available literature and relevant health technology assessments. One-way sensitivity analyses were performed for each model variable.Results: In the base-case scenario, RFTM plus SoC was a dominant strategy compared to SoC alone. RFTM plus SoC was associated with cost savings of $38,593 per additional ulcer avoided versus SoC alone, and $8027 per patient per year on average compared to SoC alone. These results were highly robust to one-way sensitivity analysis; all scenarios remained dominant if compliance was ≥ 13%.Conclusion: RFTM is a cost-effective addition to SoC in patients with diabetic neuropathy at a moderate-to-high risk of DFU and subsequent amputation. Further, reduction in DFU and associated complications may result in improvements in the patient’s quality of life and mental health. Future studies are needed to evaluate the compliance and reduction of DFU occurrence in patients on RFTM.Keywords: diabetes mellitus, diabetic foot, technology assessment, biomedical, cost-benefit analysis, cost savings, decision trees