Cost-utility analysis of treating severe peripheral arterial occlusive disease

Abstract

The importance of economic analysis in public health constantly increases due to the persistent debate on restricted resources. The treatment of peripheral arterial occlusive disease (PAOD) in its severe stages is the object of this health economic evaluation. The disease course of patients with severe PAOD is simulated in a Markov model according to the available treatment options: prostaglandin El, percutaneous transluminal angioplasty and bypass. Long-term treatment strategies are composed of two therapy options. The expected costs from societal perspective, life expectancy and quality of life are included in a cost-utility analysis. The remaining life expectancy of a patient in the stage III/IV (aged 65–75 years) is maximized by the repeated use of bypass on average of 4.7 years. Considering quality of life, this therapy strategy can provide the best results with 2.92 QALY. Repeated infusion of PGE1 is cost-effective with 4,944.19ε/QALY. The results are analyzed in a sensitivity analysis. Considering cost-effectiveness, conservative interventions for treating patients with PAOD in severe stages must be taken into account. Further data about competitive cost-effectiveness of the alternative therapy options is necessary for a valid estimation of costs and quality of life in patients with PAOD.