OBJECTIVES: Peripheral arterial disease (PAD) is mainly caused by atherosclerosis that reduces blood flow to the limbs. Prosthetic vascular grafts are frequently used in lower limb bypass procedures in occluded or stenosed arteries. In Germany, annual PAD in-hospital treatment costs have been rising to over €2.56 billion with over 18,000 major amputations performed annually, posing a significant financial burden to healthcare payers. This study assessed the economic value to payers over three years, of adopting the GORE® PROPATEN® Vascular Graft with Heparin end point covalent bond (G-PVG) compared to standard ePTFE grafts (S-VG).

METHODS: A Markov model was developed to measure costs and clinical consequences over three years of treating patients with G-PVG compared to S-VG. Clinical outcomes, including occlusion, amputation and mortality rates were based on a meta-analysis of clinical publications. Procedures unit costs were sourced from German DRG rates and other public databases, costs of post-amputation rehabilitation care in Germany were sourced from published literature. Patient treatment pathways in Germany were verified by German KOL survey. The healthcare payer perspective was used.

RESULTS: At the end of three years the average treatment costs (per patient) were 37% lower for G-PVG, €47,592, compared to €75,425 for S-VG, delivering savings of €27,833. Over 50% of the savings came from preventing amputations and subsequent cost of care and rehabilitation. Modelling a cohort of 100 patients in each arm, compared to S-VG, the G-PVG arm had 36% fewer revision procedures (197 vs. 308) and 28% more patients had amputation free survival (55 vs. 43). The results were sensitive to clinical performance rates.

CONCLUSIONS: Adopting G-PVG grafts could save to payers €27,833 per patient in treatment costs and improve patient outcomes by reducing revision procedures and amputations. GORE® PROPATEN® Vascular Graft with Heparin end point covalent bond demonstrates proven clinical outcomes and measurable economic value.