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Medical cost savings from pentoxifylline therapy in chronic occlusive arterial disease
K Neels1, S Finkelstein, C Douglass
1Quintiles, Inc., Cambridge, Massachusetts.
Insights
Therapeutic dosages of pentoxifylline significantly reduce medical costs for chronic occlusive arterial disease (COAD) patients by preventing costly procedures. Annual savings range from $69 to $3090 per patient.
Area of Science:
- Vascular Medicine
- Health Economics
Background:
- Chronic occlusive arterial disease (COAD) often necessitates invasive diagnostics and surgeries.
- Pentoxifylline is a medication used in managing peripheral arterial disease.
Purpose of the Study:
- To assess direct medical cost savings of therapeutic versus lower dosages of pentoxifylline for COAD.
- To evaluate the economic impact of pentoxifylline therapy on healthcare utilization.
Main Methods:
- Secondary analysis of a population-based historical cohort study.
- Cost analysis based on 1989 Medicare expenditures in 4 US states.
- Case-mix adjustment and sensitivity analysis were performed.
Main Results:
- Pentoxifylline therapy reduced average hospital costs by $1173 per patient annually.
- Overall savings of $965 per patient were realized after accounting for outpatient visits and drug costs.
- Sensitivity analysis indicated potential annual savings between $69 and $3090 per patient.
Conclusions:
- Pentoxifylline therapy at therapeutic dosages substantially reduces direct medical costs for COAD patients.
- Savings are primarily achieved by reducing the need for invasive diagnostic and surgical procedures.
- The findings support the cost-effectiveness of pentoxifylline in managing COAD.
Abstract:
This article assesses the direct medical cost savings associated with therapeutic dosages of pentoxifylline therapy compared with lower dosages in treating chronic occlusive arterial disease (COAD). The savings accrue from elimination of invasive diagnostic measures or a number of surgical procedures received by patients with COAD during hospital admissions. Findings are based on a secondary analysis of results presented in a previously published report of a population based historical cohort study. Patients in this study were severely enough afflicted by the disease that most were under the care of vascular specialists and many underwent surgery to restore normal blood flow. Costs are based on charges from Medicare expenditures in 4 US states in 1989. A case-mix adjustment procedure was applied and a sensitivity analysis was conducted on key assumptions and variables in the cost savings model. Pentoxifylline therapy reduced average hospital costs per patient by $US1173 per year (1989 dollars). After further adjustment for the costs of outpatient visits, other related drugs and the drug acquisition cost, an overall saving of $US965 would still be realised with a patient who received the full therapeutic dose of pentoxifylline. Sensitivity analysis suggests total annual direct medical cost savings between $US69 and $US3090 per patient. Hence, under the most plausible assumptions regarding choice of procedures, study design and patient population, and considering the possibility that diagnostic and surgical costs are delayed but not prevented, pentoxifylline therapy substantially reduces direct medical costs.