Significant Savings with a Stepped Care Model for Treatment of Patients with Intermittent Claudication

Abstract

Implementation of a SCM treatment for patients with IC may lead to significant savings of health care resources.

Cost-effectiveness of supervised exercise therapy compared with endovascular revascularization for intermittent claudication

“…‡Estimated standard error owing to lack of published data. §Cost of secondary intervention endovascular revascularization (ER)/open revascularization (OR) was calculated by combining separate costs, assuming an OR : ER ratio of 10 : 293 16 for intermittent claudication and 10 : 27 29 for critical leg ischaemia. PAD, peripheral arterial disease; SET, supervised exercise therapy.…”

“…However, access to adequate SET programmes worldwide is limited 13,14 . Furthermore, in contrast to ER they are often not, or only partially, reimbursed by insurance plans 15,16 . As a result, SET remains underutilized in the treatment of IC.…”

“…Previous cost-effectiveness studies 17 -19 found a SET-first approach to be less expensive than ER, and equally effective. Implementation of a SET-first approach in the treatment of IC could lead to significant savings in terms of healthcare resources 16 . However, these studies either considered a limited time horizon of 12-15 months 18,19 , or did not include effectiveness 16,17 .…”

Screening and Basic Workup of a Patient with Peripheral Vascular Disease – A Primer of Physicians

“…12-week supervised exercise programs have been shown to improve exercise performance and quality of life in PAD [46]. They are also more cost-effective than endovascular revasculization, as is a stepped approach of exercise therapy followed by endovascular revascularization than revascularization alone [48,47]. Supervised exercise in a hospital or outpatient facility is recommended for all patients with PAD [49].…”

Intermittent Claudication: The Importance of Non-Invasive Treatment in the Femoro-Popliteal Tract

“…These patients will be exposed to increased risks of surgical and medical complications and enormous medical costs that we can easily prevent by offering the best medical treatment and adequate encouragement for starting a supervised training program that is surely more fatiguing but at least as effective as invasive procedures [7,8,13]. A recent cost-analysis study estimated savings of up to 33 million euros per year if a supervised exercise training first approach for intermittent claudication is followed in the Dutch healthcare system [14].…”