Medical device start-ups are increasingly being challenged to justify the economic value of their innovation at an early stage, in a manner that is acceptable to the health technology assessment (HTA) community. The experience of introducing a medical device start-up company to health economics methods is described, outlining the construction of a basic Markov model to assess the potential cost-effectiveness of their wound healing innovation for treating diabetic foot ulcer. The model provided the start-up with the means to articulate their innovation in health economic terms. A common understanding of value between innovator and assessors is essential to improving the efficiency of taking innovations though the HTA process and into adoption.