Current status of the medical expenses for the treatment of arteriosclerosis obliterans in Japan.
OBJECTIVE
We aimed to determine the current status of the medical expenses for the treatment of arteriosclerosis obliterans (ASO) and evaluate the cost effectiveness of the medical practices employed in ASO treatment in Japan.


METHODS
We performed a prospective observational study using 140 ASO patients. The cost of the medical practices comprised the costs of outpatient treatment, pharmacological agents, and hospitalization. To compare the average monthly costs, the patients were divided into preintervention, postintervention, or conservative-therapy groups. To compare the total costs and effectiveness of each treatment, the patients who had first visited our division during the study period were classified into surgery, endovascular-revascularization (EVR), or conservative-therapy groups. The adverse reactions of the 4 most popular agents for ASO were investigated, and bleeding events were assessed specifically.


RESULTS
The average monthly costs for outpatient treatment and pharmacological agents were yen 168,002 in conservative cases, yen 149,871 in preoperation cases, and yen 128,527 in postoperation cases. The mean total costs were yen 5,407,950 in conservative cases, yen 7,375,290 in surgical cases, and yen 2,631,650 in EVR cases. The average change of the gauge in clinical status was 0.57 in conservative cases, 2.13 in surgical cases, and 2.25 in EVR cases. Warfarin induced more bleeding complications than the other agents.


CONCLUSIONS
The costs of pharmacological agents represented much of the medical costs in any treatment groups.
Isaji
T
T
Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Japan.
Takayama
T
T
Endo
A
A
Akai
A
A
Kudo
M
M
Kagaya
H
H
Suzuki
J
J
Hashimoto
T
T
Hoshina
K
K
Kimura
H
H
Okamoto
H
H
Shigematsu
K
K
Miyata
T
T
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000191:economics; D000671:Amputation, Surgical / Q000191:economics; D000800:Angioplasty, Balloon / Q000191:economics / Q000295:instrumentation; D001162:Arteriosclerosis Obliterans / Q000191:economics* / Q000628:therapy*; D002317:Cardiovascular Agents / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D005260:Female; D017048:Health Care Costs; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D010043:Outcome and Process Assessment, Health Care / Q000191:economics*; D011446:Prospective Studies; D015607:Stents / Q000191:economics; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000191:economics*
D002317:Cardiovascular Agents