An analysis of the economic impact of drug-coated balloon use for the treatment of peripheral artery disease

Abstract

<p><strong>Background</strong>: Drug-coated balloons (DCBs) are an alternative for patients with peripheral arterial disease. Costs and re-intervention rates are potentially reduced compared to other technologies. We assessed the economic impact of these endovascular therapies.</p><p><strong>Methods</strong>: An Italian National Healthcare Service-perspective budget impact model with a 5-year horizon was developed to compare relative costs of 4 index procedures (plain old balloon angioplasty (POBA), DCBs, and bare-metal and drug-eluting stents (BMSs, DESs)) based on 1-year repeat-procedure rates (target-lesion revascularization (TLR)). A published systematic review of TLR rates in patients with femoral-popliteal disease undergoing these treatments was used to measure effectiveness. Costs associated with each treatment were derived from diagnosis-related group tariffs. A decision analytic model was developed to estimate 1-year costs for index procedures and possible revascularizations.</p><p> </p><p><strong>Results</strong>: Pooled TLR rates show clear patient benefits for DCBs (6.9%) compared with POBA (21.6%) and BMSs (14.2%) and non-inferiority vs. DESs (7.3%). One-year payments for index and repeat interventions (by TLR rate) showed that DCBs were the least costly strategy, saving ~€1,000/patient vs. POBA. The potential savings were €8.7M, assuming 5% annual increase in DCB adoption over 5 years. <strong></strong></p><p><strong>Conclusions</strong>: Despite initial higher investment, DCB represent a cost-saving alternative to other technologies. <strong></strong></p>

Cost-effectiveness analysis of drug-coated therapies in the superficial femoral artery

“…Decision analytic models have been performed in the German health care market, National Health Service in the United Kingdom, and Italian National Health Service. 38,43,44 In all analyses, drug-eluting therapies have been associated with cost savings to the health care system in question, with DCBs generally being found most cost-effective.…”

Implementation of drug-eluting stents for the treatment of femoropopliteal disease provides significant cost-to-system savings in a single-state outpatient simulation

“…Despite this, a number of models have shown favorable cost effectiveness with drug-eluting therapies compared with BMS or percutaneous transluminal angioplasty. 19,20,23,24 These analyses provide excellent insight into the per-patient cost impact of drug-eluting therapies but are limited in their ability to explain population-wide budget impacts. Although cost-effectiveness analyses can provide a estimation of per-patient economic efficiency, a budget impact analysis is needed to understand the financial consequences related to the uptake and diffusion of technologies to determine their affordability.…”