1 Clinical and Interventional Angiology, Swiss Cardiovascular Center, Inselspital, University Hospital Bern, Switzerland.
J Endovasc Ther. 2013 Dec;20(6):819-25. doi: 10.1583/13-4416R.1.
To explore the cost-effectiveness of using drug-eluting balloon (DEB) angioplasty for the treatment of femoropopliteal arterial lesions, which has been shown to significantly lower the rates of target lesion revascularization (TLR) compared with standard balloon angioplasty (BA).
A simplified decision-analytic model based on TLR rates reported in the literature was applied to baseline and follow-up costs associated with in-hospital patient treatment during 1 year of follow-up. Costs were expressed in Swiss Francs (sFr) and calculated per 100 patients treated. Budgets were analyzed in the context of current SwissDRG reimbursement figures and calculated from two different perspectives: a general budget on total treatment costs (third-party healthcare payer) as well as a budget focusing on the physician/facility provider perspective.
After 1 year, use of DEB was associated with substantially lower total inpatient treatment costs when compared with BA (sFr 861,916 vs. sFr 951,877) despite the need for a greater investment at baseline related to higher prices for DEBs. In the absence of dedicated reimbursement incentives, however, use of DEB was shown to be the financially less favorable treatment approach from the physician/facility provider perspective (12-month total earnings: sFr 179,238 vs. sFr 333,678).
Use of DEBs may be cost-effective through prevention of TLR at 1 year of follow-up. The introduction of dedicated financial incentives aimed at improving DEB reimbursements may help lower total healthcare costs.
探讨药物洗脱球囊（DEB）血管成形术治疗股腘动脉病变的成本效益，该方法与标准球囊血管成形术（BA）相比，显著降低了靶病变血运重建（TLR）的发生率。
根据文献中报道的 TLR 发生率，应用简化的决策分析模型，对基线和随访期间 1 年内与住院患者治疗相关的成本进行了分析。成本以瑞士法郎（sFr）表示，并按每 100 例患者进行计算。在当前瑞士诊断相关分组（DRG）报销金额的背景下对预算进行了分析，并从两个不同的角度进行了计算：一种是从第三方医疗支付者的角度计算总治疗成本的总体预算，另一种是从医生/医疗机构提供者的角度计算专注于医生/医疗机构提供者视角的预算。
与 BA 相比，在 1 年后，DEB 的总住院治疗成本明显较低（sFr861,916 比 sFr951,877），尽管 DEB 的初始投资更高，价格更高。然而，在没有专门的报销激励措施的情况下，从医生/医疗机构提供者的角度来看，DEB 的使用在经济上并不是更有利的治疗方法（12 个月的总收益：sFr179,238 比 sFr333,678）。
DEB 的使用可能具有成本效益，因为在 1 年的随访期间可以预防 TLR。引入旨在提高 DEB 报销的专门财务激励措施可能有助于降低总医疗成本。
