OBJECTIVES: Iliac branch devices (IBD) have become the standard for treating iliac and aorto-iliac aneurysms, facilitating preservation of the hypogastric arteries. The objective of this study was to compare the costs of treating patients in France with either of the two IBDs that are available.

METHODS: A retrospective analysis was conducted on the SNDS database, which contains individualized data on reimbursable healthcare services for almost the entire French population. Patients in whom the e-PTFE IBD (Group 1) or polyester IBD (Group 2) was implanted between November 1, 2017 and the end of 2019 were identified from implant and/or procedure codes. Individual propensity score matching was undertaken based on demographics and clinical characteristics at index. Records of inpatient and outpatient follow-up care were retrieved from the time of the index procedure to the end of 2020. All healthcare resource expenditure from index hospitalization to completion of follow-up were documented and costed from the perspective of public health insurance. Healthcare resource consumption was assessed against official national tariffs.

RESULTS: A total of 263 patients were identified per group. Mean age was 72.5 ± 8.9 and 73.8 ± 8.8 years and 96.2% and 95.8% were male, respectively. The adjusted estimated mean healthcare cost for the entire follow-up period (median approx. 24 months) was €30,012 in group 1 (95% CI; [€29,304; €30,720]) and €34,206 in group 2 (95% CI; [€33,473; €34,939]. This difference was statistically significant (p-value = 0.0030). Intensive care was the principal driver of inpatient costs at €567 and €999, respectively (no statistically significant difference). Costs for paramedic consultations, medical devices, biological tests and medical transportation differed significantly between the two groups.

CONCLUSIONS: Endovascular repair of aorto-iliac aneurysms was associated with lower healthcare resource consumption and costs when using the e-PTFE IBD rather than the polyester IBD in real life.