Treatment costs of peripheral arterial occlusive disease in Germany: a comparison of costs and efficacy.

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. 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.(ABSTRACT TRUNCATED AT 250 WORDS)