title: Cost-effectiveness of cilostazol, naftidrofuryl oxalate, and pentoxifylline for the treatment of intermittent claudication in people with peripheral arterial disease.
abstract: We assessed the cost-effectiveness of cilostazol, naftidrofuryl oxalate, and pentoxifylline for intermittent claudication due to peripheral arterial disease (PAD) in adults whose symptoms continue despite a period of conventional management. A Markov decision model was developed to assess the lifetime costs and benefits of each vasoactive drug compared to no vasoactive drug and with each other. Regression analysis was undertaken to model the relationship between maximum walking distance and utility. Resource use data were sourced from the literature and sensitivity analyses were undertaken. Naftidrofuryl oxalate is more effective and less costly than cilostazol and pentoxifylline and has an estimated cost per quality-adjusted life year gained of around £6070 compared to no vasoactive drug. The analysis uses effectiveness evidence from a network meta-analysis. In contrast to previous guidelines recommending cilostazol, the analysis suggests that naftidrofuryl oxalate is the only vasoactive drug for PAD which is likely to be cost-effective.
authors: 1School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom.
authors: Yang
authors: Y
authors: Meng
authors: Hazel
authors: H
authors: Squires
authors: John W
authors: JW
authors: Stevens
authors: Emma
authors: E
authors: Simpson
authors: Sue
authors: S
authors: Harnan
authors: Steve
authors: S
authors: Thomas
authors: Jonathan
authors: J
authors: Michaels
authors: Gerard
authors: G
authors: Stansby
authors: Mark E
authors: ME
authors: O'Donnell
mesh_terms: D000077407:Cilostazol; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D006801:Humans; D007383:Intermittent Claudication / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D008390:Markov Chains; D009257:Nafronyl / Q000191:economics / Q000627:therapeutic use*; D010431:Pentoxifylline / Q000191:economics / Q000627:therapeutic use*; D058729:Peripheral Arterial Disease / Q000150:complications*; D013777:Tetrazoles / Q000191:economics / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000191:economics / Q000627:therapeutic use*
chemical_list: D013777:Tetrazoles; D014665:Vasodilator Agents; D009257:Nafronyl; D000077407:Cilostazol; D010431:Pentoxifylline
keywords: cilostazol; cost-effectiveness analysis; intermittent claudication; naftidrofuryl oxalate; pentoxifylline; peripheral arterial disease