PMID- 38109215
OWN - NLM
STAT- MEDLINE
DCOM- 20240410
LR  - 20240410
IS  - 0301-1526 (Print)
IS  - 0301-1526 (Linking)
VI  - 53
IP  - 2
DP  - 2024 Apr
TI  - Cost-effectiveness analysis of intravascular ultrasound-guided peripheral 
      vascular interventions in patients with femoropopliteal peripheral artery 
      disease.
PG  - 135-144
LID - 10.1024/0301-1526/a001109 [doi]
AB  - Background: Intravascular ultrasound (IVUS)-guided percutaneous transluminal 
      angioplasty (PTA) might offer clinical benefits compared to angiography-guided 
      PTA in patients with peripheral artery disease (PAD). A cost-effectiveness model 
      was developed to examine the benefits and costs of IVUS-guided PTA versus 
      angiography-guided PTA in PAD patients with femoropopliteal (FP) occlusive 
      disease. Methods: A two-step model (a one-year decision tree followed by a 
      lifetime semi-Markov model) was developed from a German healthcare payer 
      perspective to estimate the costs and outcomes over a one-year and lifetime 
      horizon. Clinical events included target lesion revascularization (TLR), 
      amputation, and death. Transition probabilities and utility values were derived 
      from published literature. Healthcare costs were based on German Diagnosis 
      Related Groups (DRG) codes. Costs and outcomes were discounted at a rate of 3% 
      per year. The incremental cost-effectiveness ratio (ICER) was calculated, and 
      sensitivity analyses were performed to assess the robustness of the results. 
      Results: In the one-year horizon, IVUS-guided PTA resulted in incremental 
      quality-adjusted life-years (QALY) and costs of 0.02 and euro919 per patient 
      respectively, with a corresponding ICER of euro45,195/QALY gained versus 
      angiography-guided PTA. In the lifetime horizon, IVUS-guided PTA outperforms 
      angiography-guided PTA; it was associated with a cost saving of euro46 per patient 
      and incremental QALY of 0.22. Utility value for post-TLR, as well as 
      probabilities of death and TLR had the greatest impact on the one-year ICER, 
      while cost of TLR and probabilities of TLR and amputation influenced the lifetime 
      ICER most. The probability of IVUS-guided PTA being cost-effective at a 
      willingness-to-pay (WTP) threshold of euro50,000/QALY was 50.4% in the one-year 
      horizon and increased to 85.9% in the lifetime horizon. Conclusions: In this 
      analysis IVUS-guided PTA among patients with symptomatic FP atherosclerosis was 
      cost-saving in a lifetime horizon from the German healthcare payer perspective.
FAU - Lichtenberg, Michael
AU  - Lichtenberg M
AUID- ORCID: 0000-0003-2647-9876
AD  - Klinikum Arnsberg GmbH, Karolinen-Hospital, Arnsberg-Husten, Germany.
FAU - Mustapha, Jihad
AU  - Mustapha J
AD  - Advanced Cardiac & Vascular Centers, Grand Rapids, Michigan, USA.
FAU - Tan, Yan Zhi
AU  - Tan YZ
AUID- ORCID: 0000-0002-4266-1363
AD  - Health Economics and Outcomes Research, Monitor Deloitte, Brussels, Belgium.
FAU - Stavroulakis, Konstantinos
AU  - Stavroulakis K
AUID- ORCID: 0000-0002-9775-9210
AD  - Department of Vascular and Endovascular Surgery, Ludwig Maximilian University of 
      Munich, Germany.
FAU - Meijer, Catherina
AU  - Meijer C
AUID- ORCID: 0000-0002-8487-3858
AD  - Health Economics and Outcomes Research, Monitor Deloitte, Brussels, Belgium.
FAU - Baviere, Henri Vanden
AU  - Baviere HV
AUID- ORCID: 0000-0002-2264-171X
AD  - Chief Medical Office - Health Economics & Outcomes Research, Philips, Amsterdam, 
      The Netherlands.
AD  - Erasmus University College, Brussels, Belgium.
LA  - eng
PT  - Journal Article
DEP - 20231218
PL  - Switzerland
TA  - Vasa
JT  - VASA. Zeitschrift fur Gefasskrankheiten
JID - 0317051
SB  - IM
MH  - Humans
MH  - *Cost-Effectiveness Analysis
MH  - Cost-Benefit Analysis
MH  - *Peripheral Arterial Disease/diagnostic imaging/therapy
MH  - Femoral Artery/diagnostic imaging
MH  - Ultrasonography, Interventional
OTO - NOTNLM
OT  - IVUS guided endovascular treatment
OT  - cost-effectiveness
OT  - healthcare-costs
OT  - markov-model
OT  - peripheral artery disease
EDAT- 2023/12/18 18:41
MHDA- 2024/04/10 06:42
CRDT- 2023/12/18 12:22
PHST- 2024/04/10 06:42 [medline]
PHST- 2023/12/18 18:41 [pubmed]
PHST- 2023/12/18 12:22 [entrez]
AID - 10.1024/0301-1526/a001109 [doi]
PST - ppublish
SO  - Vasa. 2024 Apr;53(2):135-144. doi: 10.1024/0301-1526/a001109. Epub 2023 Dec 18.