Download PDF
Thromb Haemost 2014; 111(01): 19-28
DOI: 10.1160/TH13-06-0498
Review Article
Schattauer GmbH

A systematic review of model-based economic evaluations of diagnostic and therapeutic strategies for lower extremity artery disease

Anil Vaidya
1   Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre Maastricht, The Netherlands
2   School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
,
Manuela A. Joore
1   Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre Maastricht, The Netherlands
2   School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
,
Arina J. ten Cate-Hoek
3   Laboratory for Clinical Thrombosis and Haemostasis, Department of Internal Medicine, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, the Netherlands
,
Marie-Claire Kleinegris
3   Laboratory for Clinical Thrombosis and Haemostasis, Department of Internal Medicine, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, the Netherlands
,
Hugo ten Cate
3   Laboratory for Clinical Thrombosis and Haemostasis, Department of Internal Medicine, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, the Netherlands
,
Johan L. Severens
4   Institute of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
› Author Affiliations Financial support: This research was performed within the framework of CTMM, the Centre for Translational Molecular Medicine (http://www.ctmm.nl), project INCOAG (Innovative Coagulation Diagnostics) and supported by the Dutch Heart Foundation.
Further Information

Publication History

Received: 20 June 2013

Accepted after major revision: 23 August 2013

Publication Date:
29 November 2017 (online)

Also available at
    Permissions and Reprints

Summary

Lower extremity artery disease (LEAD) is a sign of wide spread atherosclerosis also affecting coronary, cerebral and renal arteries and is associated with increased risk of cardiovascular events. Many economic evaluations have been published for LEAD due to its clinical, social and economic importance. The aim of this systematic review was to assess modelling methods used in published economic evaluations in the field of LEAD. Our review appraised and compared the general characteristics, model structure and methodological quality of published models. Electronic databases MEDLINE and EMBASE were searched until February 2013 via OVID interface. Cochrane database of systematic reviews, Health Technology Assessment database hosted by National Institute for Health research and National Health Services Economic Evaluation Database (NHSEED) were also searched. The methodological quality of the included studies was assessed by using the Philips’ checklist. Sixteen model-based economic evaluations were identified and included. Eleven models compared therapeutic health technologies; three models compared diagnostic tests and two models compared a combination of diagnostic and therapeutic options for LEAD. Results of this systematic review revealed an acceptable to low methodological quality of the included studies. Methodological diversity and insufficient information posed a challenge for valid comparison of the included studies. In conclusion, there is a need for transparent, methodologically comparable and scientifically credible modelbased economic evaluations in the field of LEAD. Future modelling studies should include clinically and economically important cardiovascular outcomes to reflect the wider impact of LEAD on individual patients and on the society.

Keywords

Lower extremity artery disease - economic evaluation - decision analytic model - systematic review

 

  • References

  • 1 European Stroke O, Tendera M, Aboyans V. et al. ESC Guidelines on the diagnosis and treatment of peripheral artery diseases: Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries: the Task Force on the Diagnosis and Treatment of Peripheral Artery Diseases of the European Society of Cardiology (ESC). Eur Heart J 2011; 32: 2851-2906.
    CrossrefPubMedGoogle Scholar
  • 2 Criqui MH, Langer RD, Fronek A. et al. Mortality over a period of 10 years in patients with peripheral arterial disease. N Engl J Med 1992; 326: 381-386.
    CrossrefPubMedGoogle Scholar
  • 3 Regensteiner JG, Hiatt WR, Coll JR. et al. The impact of peripheral arterial disease on health-related quality of life in the Peripheral Arterial Disease Awareness, Risk, and Treatment: New Resources for Survival (PARTNERS) Program. Vasc Med 2008; 13: 15-24.
    CrossrefPubMedGoogle Scholar
  • 4 Migliaccio-Walle K, Caro JJ, Ishak KJ. et al. Costs and medical care consequences associated with the diagnosis of peripheral arterial disease. Pharm Econom 2005; 23: 733-742.
    CrossrefPubMedGoogle Scholar
  • 5 Moriarty JP, Murad MH, Shah ND. et al. A systematic review of lower extremity arterial revascularization economic analyses. J Vasc Surg 2011; 54: 1131-1144 e1
    CrossrefPubMedGoogle Scholar
  • 6 Garcia-Altes A, Peiro S. A systematic review of cost-effectiveness evidence of endoscopic saphenous vein harvesting: is it efficient?. Eur J Vasc Endovasc Surg 2011; 41: 831-836.
    CrossrefPubMedGoogle Scholar
  • 7 Drummond MF, Sculpher MJ, Torrance GW. Methods for the economic evaluation of health care programmes. Oxford University Press; 2005
    Google Scholar
  • 8 Pignone M, Saha S, Hoerger T. et al. Challenges in systematic reviews of economic analyses. Ann Int Med 2005; 142: 1073-1079.
    CrossrefPubMedGoogle Scholar
  • 9 Philips Z, Ginnelly L, Sculpher M. et al. Review of guidelines for good practice in decision-analytic modelling in health technology assessment. Health Technol Assess 2004; 8: iii-iv ix-xi, 1-158.
    CrossrefPubMedGoogle Scholar
  • 10 Bosch JL, Haaring C, Meyerovitz MF. et al. Cost-effectiveness of percutaneous treatment of iliac artery occlusive disease in the United States. AJR Am J Roent-genol 2000; 175: 517-521.
    CrossrefPubMedGoogle Scholar
  • 11 Bosch JL, Tetteroo E, Mali WP. et al. Iliac arterial occlusive disease: cost-effectiveness analysis of stent placement versus percutaneous transluminal angio-plasty. Dutch Iliac Stent Trial Study Group. Radiology 1998; 208: 641-648.
    CrossrefPubMedGoogle Scholar
  • 12 Coffi SB, Ubbink DT, Dijkgraaf MG. et al. Cost-effectiveness of identifying aor-toiliac and femoropopliteal arterial disease with angiography or duplex scanning. Eur J Radiol 2008; 66: 142-148.
    CrossrefPubMedGoogle Scholar
  • 13 de Vries SO, Visser K, de Vries JA. et al. Intermittent claudication: cost-effectiveness of revascularization versus exercise therapy. Radiology 2002; 222: 25-36.
    CrossrefPubMedGoogle Scholar
  • 14 Guest JF, Davie AM, Clegg JP. Cost effectiveness of cilostazol compared with naftidrofuryl and pentoxifylline in the treatment of intermittent claudication in the UK. Curr Med Res Opin 2005; 21: 817-826.
    CrossrefPubMedGoogle Scholar
  • 15 Holler D, Claes C, von der Schulenburg JM. Cost-utility Analysis of Treating Severe Peripheral Arterial Occlusive Disease. Int J Angiol 2006; 15: 25-33.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 16 Hunink MG, Wong JB, Donaldson MC. et al. Revascularization for femoropo-pliteal disease. A decision and cost-effectiveness analysis. J Am Med Assoc 1995; 274: 165-171.
    CrossrefPubMedGoogle Scholar
  • 17 Muradin GS, Myriam Hunink MG. Cost and patency rate targets for the development of endovascular devices to treat femoropopliteal arterial disease. Radiology 2001; 218: 464-469.
    CrossrefPubMedGoogle Scholar
  • 18 Sculpher M, Michaels J, McKenna M. et al. A cost-utility analysis of laser-assisted angioplasty for peripheral arterial occlusions. Int J Technol Assess Health Care 1996; 12: 104-125.
    CrossrefPubMedGoogle Scholar
  • 19 Sigvant B, Henriksson M, Lundin F. et al. Asymptomatic peripheral arterial disease: is pharmacological prevention of cardiovascular risk cost-effective?. Eur J Cardiovasc Prevent Rehabil 2011; 18: 254-261.
    CrossrefPubMedGoogle Scholar
  • 20 Squires H, Simpson E, Meng Y. et al. A systematic review and economic evaluation of cilostazol, naftidrofuryl oxalate, pentoxifylline and inositol nicotinate for the treatment of intermittent claudication in people with peripheral arterial disease. Health Technol Assess 2011; 15: 1-210.
    CrossrefPubMedGoogle Scholar
  • 21 Treesak C, Kasemsup V, Treat-Jacobson D. et al. Cost-effectiveness of exercise training to improve claudication symptoms in patients with peripheral arterial disease. Vasc Med 2004; 9: 279-285.
    CrossrefPubMedGoogle Scholar
  • 22 Visser K, de Vries SO, Kitslaar PJ. et al. Cost-effectiveness of diagnostic imaging work-up and treatment for patients with intermittent claudication in The Netherlands. Eur J Vasc Endovasc Surg 2003; 25: 213-223.
    CrossrefPubMedGoogle Scholar
  • 23 Visser K, Kock MC, Kuntz KM. et al. Cost-effectiveness targets for multi-detector row CT angiography in the work-up of patients with intermittent claudi-cation. Radiology 2003; 227: 647-656.
    CrossrefPubMedGoogle Scholar
  • 24 Visser K, Kuntz KM, Donaldson MC. et al. Pretreatment imaging workup for patients with intermittent claudication: a cost-effectiveness analysis. J Vasc In-terv Radiol 2003; 14: 53-62.
    PubMedGoogle Scholar
  • 25 Yin D, Baum RA, Carpenter JP. et al. Cost-effectiveness of MR angiography in cases of limb-threatening peripheral vascular disease. Radiology 1995; 194: 757-764.
    CrossrefPubMedGoogle Scholar
  • 26 Weinstein MC, O’Brien B, Hornberger J. et al. Principles of good practice for decision analytic modeling in health-care evaluation: report of the ISPOR Task Force on Good Research Practices--Modeling Studies. Value Health 2003; 6: 9-17.
    CrossrefPubMedGoogle Scholar
  • 27 Ambrosetti M, Salerno M, Boni S. et al. Economic evaluation of a short-course intensive rehabilitation program in patients with intermittent claudication. Int Angiol 2004; 23: 108-113.
    PubMedGoogle Scholar
  • 28 Belcaro G, Nicolaides AN, Agus G. et al. PGE 1 Treatment of Severe Intermittent Claudication (Short-Term Versus Long-Term, Associated with Exercise). Angiology 2000; 51: S15-S26.
    CrossrefPubMedGoogle Scholar
  • 29 Duda SH, Tepe G, Bala M. et al. Economic value of thrombolysis with adjunctive abciximab in patients with subacute peripheral arterial occlusion. Pharm Econ- om 2002; 20: 203-213.
    CrossrefPubMedGoogle Scholar
  • 30 Geitung JT, Wikstrom T, Zeuchner J. et al. Cost-effectiveness of colour duplex sonography compared with angiography of the pelvis and lower limb. Eur Radiol 1996; 6: 481-484.
    CrossrefPubMedGoogle Scholar
  • 31 Ikeda S, Kobayashi M, Fukuhara S. et al. Cost-effectiveness of Liple (LipoPGE1) for arteriosclerosis obliterans patients in Japan: an economic evaluation using the EQ-5D instrument. Int Angiol 2006; 25: 169-174.
    PubMedGoogle Scholar
  • 32 Malagoni AM, Vagnoni E, Felisatti M. et al. Evaluation of patient compliance, quality of life impact and cost-effectiveness of a “test in-train out” exercise-based rehabilitation program for patients with intermittent claudication. Circ J 2011; 75: 2128-2134.
    CrossrefPubMedGoogle Scholar
  • 33 Ouriel K, Kolassa M, DeWeese JA. et al. Economic implications of thrombolysis or operation as the initial treatment modality in acute peripheral arterial occlusion. Surgery 1995; 118: 810-814.
    CrossrefPubMedGoogle Scholar
  • 34 Spronk S, Bosch JL, den Hoed PT. et al. Cost-effectiveness of endovascular rev-ascularization compared to supervised hospital-based exercise training in patients with intermittent claudication: a randomized controlled trial. J Vasc Surg 2008; 48: 1472-1480.
    CrossrefPubMedGoogle Scholar
  • 35 van Asselt AD, Nicolai SP, Joore MA. et al. Cost-effectiveness of exercise therapy in patients with intermittent claudication: supervised exercise therapy versus a ‘go home and walk’ advice. Eur J Vasc Endovasc Surg 2011; 41: 97-103.
    CrossrefPubMedGoogle Scholar
  • 36 van Breda A, Graor RA, Katzen BT. et al. Relative cost-effectiveness of urokinase versus streptokinase in the treatment of peripheral vascular disease. J Vasc Inter-vent Radiol 1991; 2: 77-87.
    CrossrefPubMedGoogle Scholar
  • 37 Lee HL, Mehta T, Ray B. et al. A non-randomised controlled trial of the clinical and cost effectiveness of a Supervised Exercise Programme for claudication. Eur J Vasc Endovasc Surg 2007; 33: 202-207.
    CrossrefPubMedGoogle Scholar