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A Budget Impact Model for the use of Drug-Eluting Stents in Patients with Symptomatic Lower-Limb Peripheral Arterial Disease: An Australian Perspective
- Source :
- Cardiovascular and Interventional Radiology
- Publication Year :
- 2020
-
Abstract
- Purpose Improvement in long-term outcomes through innovative, cost-effective medical technologies is a focus for endovascular procedures aimed at treating symptomatic lower-limb peripheral arterial disease (PAD). The advent of drug-eluting stents (DES) has improved symptomatic PAD treatment via a reduction in high rates of target lesion revascularisation (TLR). The present study aimed to compare the 5-year financial impact of treatment with Eluvia, a new paclitaxel-eluting stent, versus treatment with Zilver PTX, a drug-coated stent, among patients in Australia by developing a budget impact model (BIM). Methods A BIM was developed from an Australian public hospital payer perspective using Australian national cost weights (AUD), published literature, and public hospital audit data. Clinical outcomes, including clinically driven TLRs (CD-TLRs), adverse events, and length of stay, were based on the 2-year results of the IMPERIAL trial, which compared Eluvia DES to Zilver PTX. Results Assuming EVP eligibility rate of 80% and DES uses rate ranging from 10 to 28% (superficial femoral artery lesions only), the 5-year model forecasted a treatment population between 14,428 and 40,399 patients. The model estimated 1499–4198 fewer CD-TLRs and 16,515–46,243 fewer hospital days with Eluvia DES use. This translated to 5-year potential savings of $4.3–$12.1 million to the Australian public hospital payer attributable to reduced CD-TLRs for Eluvia DES and $33.1–$92.6 million to Australian public hospitals owing to reduced adverse events and hospital bed days. Conclusion Eluvia DES use as treatment for symptomatic lower-limb PAD could lead to potential savings for the Australian public healthcare system based on improved patient outcomes.
- Subjects :
- Drug
Target lesion
medicine.medical_specialty
Paclitaxel
Hospital bed
medicine.medical_treatment
media_common.quotation_subject
Superficial femoral artery
Population
Audit
030204 cardiovascular system & hematology
Prosthesis Design
Paclitaxel-eluting stent
030218 nuclear medicine & medical imaging
Scientific Paper (other)
03 medical and health sciences
Peripheral Arterial Disease
0302 clinical medicine
medicine
Humans
Radiology, Nuclear Medicine and imaging
Popliteal Artery
education
Adverse effect
Vascular Patency
media_common
education.field_of_study
business.industry
Target lesion revascularisation
Australia
Stent
Drug-Eluting Stents
Femoral Artery
Treatment Outcome
Public hospital
Emergency medicine
Budget impact model
Cardiology and Cardiovascular Medicine
business
Healthcare system costs
Subjects
Details
- ISSN :
- 1432086X
- Volume :
- 44
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- Cardiovascular and interventional radiology
- Accession number :
- edsair.doi.dedup.....e8c4fda9f08cd6533ff909e8c160fe47