title: Cost-effectiveness analysis of paclitaxel-coated balloons for endovascular therapy of femoropopliteal arterial obstructions.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors: 1 Clinical and Interventional Angiology, Swiss Cardiovascular Center, Inselspital, University Hospital Bern, Switzerland.
authors: Nicolas
authors: N
authors: Diehm
authors: Henrique
authors: H
authors: Schneider
mesh_terms: D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000191:economics* / Q000295:instrumentation*; D002017:Budgets; D002317:Cardiovascular Agents / Q000008:administration & dosage* / Q000191:economics*; D020099:Coated Materials, Biocompatible / Q000191:economics*; D003251:Constriction, Pathologic; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D016527:Drug Costs; D004867:Equipment Design; D005263:Femoral Artery; D017048:Health Care Costs; D005102:Health Expenditures; D017721:Hospital Costs; D006801:Humans; D007349:Insurance, Health, Reimbursement; D007902:Length of Stay / Q000191:economics; D018803:Models, Economic; D017239:Paclitaxel / Q000008:administration & dosage* / Q000191:economics*; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000191:economics* / Q000628:therapy*; D011150:Popliteal Artery; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors; D016896:Treatment Outcome; D062666:Vascular Access Devices / Q000191:economics*
chemical_list: D002317:Cardiovascular Agents; D020099:Coated Materials, Biocompatible; D017239:Paclitaxel