Peripheral vascular disorders. A pharmacoeconomic and quality-of-life review

The purpose of this article is to review the literature on the pharmacoeconomics and quality of life of therapy interventions for patients with peripheral vascular disorders. The paper is in 4 parts. The first presents a framework for the analysis of such drug interventions, which contrasts studies that have a clinical focus with those that take a system or modelling focus and presents a research typology for studies in this area. The second part of the paper reviews pharmacoeconomic studies of selected interventions and assesses their contribution to decision-making within healthcare systems. The particular focus is on the pharmacoeconomics of therapy for atherosclerosis. While there are no studies which have evaluated the overall costs of treatment in this disease area or considered the cost effectiveness of the range of alternative treatment strategies, the issues of good clinical practice and the implicit cost effectiveness of identifying patients for treatment options and prevention strategies has been addressed. The few studies which have considered the cost consequences of particular intervention strategies, specifically pentoxifylline therapy and surgical options, are limited in scope and are difficult to generalise due to their age, their study design or the treating environment from which data are drawn. The third part reviews quality-of-life studies and, once again, assesses their contribution to formulary decision-making. There are no published studies which have compared quality-of-life outcomes associated with alternative treatment approaches or which have reported changes associated with pharmacotherapy in patients with peripheral vascular disorders. Finally, given the dearth of studies in this area, a research agenda is proposed for ongoing investigations.