Endovascular revascularization and exercise combo more effective in intermittent claudication
A combination therapy of endovascular revascularization followed by supervised exercise is clinically and economically a more attractive approach than supervised exercise only for intermittent claudication up to 12-month follow-up, suggests results from a recently published study in Cardiology .
In spite of many previous studies ,the cost-effectiveness of the combination therapy as compared with supervised exercise is still not well defined. Using data from the Endovascular Revascularization and Supervised Exercise (ERASE) study, the cost-effectiveness was analysed.
The study population included two hundred twelve patients who were randomly assigned to the combination therapy (n=106) or supervised exercise only (n=106) and were followed for 12 months. Cumulative costs per patient were collected using the in-hospital resource utilization data and cost-questionnaires. Quality-adjusted life years were estimated using the EuroQol-5D questionnaire. Incremental cost-effectiveness ratios were calculated from both the health care and societal perspective.
Results revealed some important facts.
- As compared with supervised exercise only, the combination therapy cost an additional €1.462 (99% CI, 388 to 3862) from the health care perspective and €161 (99% CI, −2286 to 3106) from the societal perspective.
- Accumulated quality-adjusted life- years during 1 year follow-up were 0.042 (99% CI, −0.009 to 0.118) higher in the combination therapy group.
- The incremental cost-effectiveness ratio was €34.810 from the health care perspective and €3.833 from the societal perspective.
- Compared with supervised exercise, at a willingness-to-pay threshold of €80.000 per quality-adjusted life-year, the combination therapy had a probability of 87% and 95% of being cost-effective from the health care and societal perspective, respectively.
The research team concluded that combined therapy was an attractive strategy both clinically and economically up to 1 year. The long-term cost-effectiveness of combined therapy remains unknown.
For full article follow the link: Endovascular Revascularization Plus Supervised Exercise Versus Supervised Exercise Only for Intermittent Claudication: A Cost-Effectiveness Analysis Circ Cardiovasc Interv, 2021 Jul 13