ISET: Peripheral arterial disease is more expensive to treat than CAD

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Both coronary artery disease (CAD) and peripheral arterial disease (PAD) are atherosclerotic cardiovascular diseases involving blocked arteries, but it costs about 5 percent more to treat a PAD patient than to treat a CAD patient, according to research presented at the 20th annual International Symposium on Endovascular Therapy (ISET) in Hollywood, Fla.

Both diseases are treated with the same methods. However, physicians tend to be more successful in the heart, potentially contributing to the cost difference.

“Patients with PAD have to be seen frequently and many of the treatments don’t last as long, so it costs more to care for these patients,” said Michael R. Jaff, DO, principal investigator of the study and director of the Massachusetts General Hospital Vascular Center in Boston.

The researchers said that blockages in the heart arteries are short and near the origin of arteries, whereas in the peripheral arteries, blockages tend to be longer and more diffuse.

The study examined a random sample of 5 percent of patients (2.8 million) in the Medicare system from 1999-2005 and performed a cost analysis on 45,814 patients who received PAD treatment during that time period. On average, based on the Medicare Standard Analytic Files, PAD patients incurred $50,110 in costs for the period of initial treatment and the year following, while treated CAD patients incurred $47,515 in costs for a similar time period, according to the researchers.

Jaff and colleagues also found that PAD is on the rise, affecting 8.2 percent in 1999 compared with 9.5 percent by 2005, most of whom were 65 or older. PAD was more common among those 75 years and older, increasing from 12.7 percent to 14.5 percent in that population during the six-year span, based on the Medicare database.

The authors wrote that patients with diabetes mellitus cost more to treat than non-diabetic patients, most likely because diabetic patients have more extensive and severe PAD.

“These data suggest that future trials of PAD therapy should take into account the high cost of treating these patients, particularly those with diabetes mellitus,” said Jaff. “When therapies work equally well, but there are cost advantages of one over the other, the less expensive therapy should be tried first.”