Direct Cost of Percutaneous Deep Vein Arterialization (PDVA) in an Italian Center
Author(s)
Di Stasi F1, Migliara B2, Feriani G2, Nicoletti C3, Busca R4, Raschellà N2
1W.L. Gore & Associati, Verona, VR, Italy, 2Ospedale P.Pederzoli, Peschiera del Garda, Italy, 3Ospadle P.Pederzoli, Peschiera del Garda, Italy, 4W.L. Gore & Associati, Milan, MI, Italy
Presentation Documents
OBJECTIVES:
Percutaneous deep vein arterialization (pDVA) has recently shown to provide a promising treatment alternative for patients with no-option chronic limb-threatening ischemia (CLTI) facing major amputation. The aim of this research is to estimate the Healthcare Resource Utilization (HRU) and average costs associated with a single limb pDVA procedure conducted in a single center in Italy.METHODS:
The cohort retrospectively included patients Rutherford class 5 and 6 and no available for an arterial revascularization between 03/2019 - 08/2021. Clinical characteristics have been detailed elsewhere. The only procedure conducted was pDVA (no further interventions being carried-out). Costs at index hospitalization and HRU were evaluated using a standard costing approach through hospital accounting system. Cost considered were: implantable and non-implantable material, length of procedure, LoS, lab testing and imaging.RESULTS:
12 patients, 75% men (15 limbs: 6 right 9 left), average 75 yo . Three patients were treated bilaterally in a staged approach. Average LoS was 6.5 days and procedure time 198 minutes involving two vascular surgeons, a radiologic-technologist, a instrumentalist. In total ten units of blood were used. DRGs associated included DRG554 ‘Other vascular procedures with complication without major cardiovascular diagnosis’ (47%) and DRG479 ‘Other procedures on the cardiovascular system without complications’. The average lab-testing costs was 315€/hospitalization; the average costs for devices implantable and non-implantable was 9’246€ and 3’907€ respectively. The overhead costs of the OR and the healthcare professionals totaled 1’597€ /procedure. No patients needed ICU. The average cost/hospitalization to perform pDVA in a single limb was 16.800€ and the average DRG reimbursement was 7.500€.CONCLUSIONS:
pDVA costs are mainly driven by material that need to be suitable for severe, heavily calcified stenotic and occluded anatomies that extend below the ankle. Based on literature data and on our experience, seems to be safe and effective to reduce major amputation in no-option CLTI patients.Conference/Value in Health Info
2022-11, ISPOR Europe 2022, Vienna, Austria
Value in Health, Volume 25, Issue 12S (December 2022)
Code
EE555
Topic
Economic Evaluation, Medical Technologies, Study Approaches
Topic Subcategory
Medical Devices, Registries
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory)