Purpose: To explore the cost-effectiveness of using
drug-eluting balloon (DEB) angioplasty for the treatment of femoropopliteal
arterial lesions, which has been shown to significantly lower the rates of
target lesion revascularization (TLR) compared with standard balloon angioplasty
(BA).
Methods: A simplified decision-analytic model based
on TLR rates reported in the literature was applied to baseline and follow-up
costs associated with in-hospital patient treatment during 1 year of follow-up.
Costs were expressed in Swiss Francs (sFr) and calculated per 100 patients
treated. Budgets were analyzed in the context of current SwissDRG reimbursement
figures and calculated from two different perspectives: a general budget on
total treatment costs (third-party healthcare payer) as well as a budget
focusing on the physician/facility provider perspective.
Results: After 1 year, use of DEB was associated
with substantially lower total inpatient treatment costs when compared with BA
(sFr 861,916 vs. sFr 951,877) despite the need for a greater investment at
baseline related to higher prices for DEBs. In the absence of dedicated
reimbursement incentives, however, use of DEB was shown to be the financially
less favorable treatment approach from the physician/facility provider
perspective (12-month total earnings: sFr 179,238 vs. sFr 333,678).
Conclusion: Use of DEBs may be cost-effective
through prevention of TLR at 1 year of follow-up. The introduction of dedicated
financial incentives aimed at improving DEB reimbursements may help lower total
healthcare costs.
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