TCT-535 I’ll Be Back – The Phenomenon of Recurrent Peripheral Vascular Interventions: Observations from the Blue Cross Blue Shield of Michigan Cardiovascular Consortium Vascular Interventions Collaborative (BMC2 VIC)

Abstract

femoropopliteal (fem-pop) artery disease with drug-coated balloons (DCB) vs. standard PTA. The overall impact of DCB use on medical care costs is unknown. Methods: We performed a prospective economic study alongside the IN.PACT SFA II trial, which randomized patients with symptomatic fem-pop disease to DCB vs. standard PTA and followed them for a minimum of 12 months. Detailed medical resource utilization data were collected and costs were assigned for all US patients using resource-based accounting (for revascularization procedures, medications and outpatient vascular care) and hospital billing data for costs associated with the index and follow-up hospitalizations for treatment of the target limb. The DCB was assigned a cost of $1350/balloon. Results: A total of 181 US patients were enrolled (121 DCB, 60 PTA). Initial hospital costs were approximately $1100/patient higher in the DCB group than the PTA group ($8258 vs. $7164, p< 0.001), driven mainly by the cost of the DCB itself (see Table). From discharge through 12 months, follow-up target-limb related medical care costs were w$750/pt lower in the DCB group, such that total 1-year costs were similar for the 2 groups ($10,034 vs. $9694, p¼0.82) with a resulting incremental cost-effectiveness ratio of $2906 per repeat revascularization avoided -similar to that for coronary drug-eluting stents.Conclusions: For patients with symptomatic fem-pop disease, use of the DCB was associated with higher initial costs compared with standard PTA, but these were largely offset by lower costs for follow-up target limb procedures through 1-year of follow-up. The cost-effectiveness of DCB for such patients appears to compare favorably with that for other cardiovascular interventions.