Treatment costs of peripheral arterial occlusive disease in Germany: a comparison of costs and efficacy
Rudofsky, G.; van Laak, H.H.
Journal of Cardiovascular Pharmacology 23(Suppl): S22-S25
1994
ISSN/ISBN: 0160-2446 PMID: 7517472 Document Number: 430430
Significant increases in the costs of the health system in all Western countries indicate the importance of both economic and efficacy studies in evaluating the various treatments for peripheral arterial occlusive disease (PAOD). On the basis of this background, an attempt was made to compare the efficacy and the costs of different treatment regimens for PAOD using data from the literature. In severe PAOD, the therapeutic approaches are supplementary methods that must be applied according to the patient's situation; the treatment cannot be chosen on the basis of its costs. In patients with claudication, different treatment alternatives such as physical exercise, oral or intravenous medical treatment, and percutaneous transluminal angioplasty (PTA) exist, and cost-efficacy comparisons can be made among these. Oral treatment with vasoactive compounds results in efficacy costs ranging from DM 37.31 ( 22.61 U.S.) to DM 146.16 ( 88.58 U.S.) per patient for a drug-induced 10% increase of pain-free walking distance (PFWD) using the cheapest therapeutic alternative dag . Long-term physical exercise (twice for 2 h/week for 24 months) leads to efficacy costs of DM 189.09 ( 114.60 U.S.) per patient for a 10% increase of PFWD. Intensive therapeutic regimens using intravenous infusions produce efficacy costs of DM 116.61 ( 98.27 U.S.) to DM 2,529.81 ( 1,533.22 U.S.) per patient, but result in an average improvement in PFWD of 21% to 62% within 2 to 4 weeks. PTA with a cost of DM 6,000 ( 3,636-40 U.S.) per intervention is the most expensive method of treatment. Therefore, therapeutic treatment of patients with claudication can be adapted to the individual requirements of the patient (large improvement of PFWD over a short period of time or continuous progression for some months), taking into account the relevant treatment costs.