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Cost/Effectiveness and Reimbursement Policies with Drug-Coated Balloons in Europe

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Drug-Coated Balloons

Abstract

The economic impact of drug-coated balloons (DCB) has been a matter of great debate in the latest years in many nations worldwide. Angioplasty with DCBs proved to be an effective and safe strategy both in coronary and peripheral interventions, mainly for the treatment of in-stent restenosis (ISR), native coronary vessel disease, and femoropopliteal disease. However, the immediate costs related to an endovascular procedure using DCBs are significantly higher than those related to a plain old balloon angioplasty (POBA), bare-metal stents (BMS), or drug-eluting stents (DES). Thus, their cost-effectiveness in the long term needed to be assessed, to test whether the reduction in target lesion revascularization (TLR) or major adverse events provided by this new class of devices may have a positive impact on national health systems. Given the existing differences between different health systems (e.g., costs, reimbursements, etc.), it is difficult to draw conclusions that could be generally accepted worldwide [1]. Nevertheless, in recent years some studies have addressed this topic, both in the field of coronary and peripheral interventions.

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References

  1. van den Berg J. Drug-eluting balloons for treatment of SFA and popliteal disease – a review of current status. Eur J Radiol. 2017;91:106–15.

    Article  Google Scholar 

  2. Stone GW, Ellis SG, Cannon L, Mann JT, Greenberg JD, Spriggs D, O’Shaughnessy CD, DeMaio S, Hall P, Popma JJ, Koglin J, Russell ME, TAXUS VI. Comparison of a polymer-based paclitaxel-eluting stent with a bare metal stent in patients with complex coronary artery disease: a randomized controlled trial. JAMA. 2005;294:1215–23.

    Article  CAS  Google Scholar 

  3. Tentzeris I, Jarai R, Farhan S, Wojta J, Schillinger M, Geppert A, Nürnberg M, Unger G, Huber K. Long-term outcome after drug-eluting stent implantation in comparison with bare metal stents: a single centre experience. Clin Res Cardiol. 2011;100:191–200.

    Article  CAS  Google Scholar 

  4. Kastrati A, Dibra A, Eberle S, Mehilli J, Suárez de Lezo J, Goy JJ, Ulm K, Schömig A. Sirolimus-eluting stents vs paclitaxel-eluting stents in patients with coronary artery disease: meta-analysis of randomized trials. JAMA. 2005;294:819–25.

    Article  CAS  Google Scholar 

  5. Windecker S, Kolh P, Alfonso F, Collet JP, Cremer J, Falk V, Filippatos G, Hamm C, Head SJ, Jüni P, Kappetein AP, Kastrati A, Knuuti J, Landmesser U, Laufer G, Neumann FJ, Richter DJ, Schauerte P, Sousa Uva M, Stefanini GG, Taggart DP, Torracca L, Valgimigli M, Wijns W, Witkowski A. 2014 ESC/EACTS guidelines on myocardial revascularization. EuroIntervention. 2015;10:1024–94.

    Article  Google Scholar 

  6. Pfisterer M, Brunner-La Rocca HP, Buser PT, Rickenbacher P, Hunziker P, Mueller C, Jeger R, Bader F, Osswald S, Kaiser C, BASKET-LATE I. Late clinical events after clopidogrel discontinuation may limit the benefit of drug-eluting stents: an observational study of drug-eluting versus bare-metal stents. J Am Coll Cardiol. 2006;48:2584–91.

    Article  CAS  Google Scholar 

  7. Bonaventura K, Leber AW, Sohns C, Roser M, Boldt LH, Kleber FX, Haverkamp W, Dorenkamp M. Cost-effectiveness of paclitaxel-coated balloon angioplasty and paclitaxel-eluting stent implantation for treatment of coronary in-stent restenosis in patients with stable coronary artery disease. Clin Res Cardiol. 2012;101:573–84.

    Article  Google Scholar 

  8. Unverdorben M, Vallbracht C, Cremers B, Heuer H, Hengstenberg C, Maikowski C, Werner GS, Antoni D, Kleber FX, Bocksch W, Leschke M, Ackermann H, Boxberger M, Speck U, Degenhardt R, Scheller B. Paclitaxel-coated balloon catheter versus paclitaxel-coated stent for the treatment of coronary in-stent restenosis: the three-year results of the PEPCAD II ISR study. EuroIntervention. 2015;11:926–34.

    Article  Google Scholar 

  9. Dorenkamp M, Boldt J, Leber AW, Sohns C, Roser M, Boldt LH, Haverkamp W, Bonaventura K. Cost-effectiveness of paclitaxel-coated balloon angioplasty in patients with drug-eluting stent restenosis. Clin Cardiol. 2013;36:407–13.

    Article  Google Scholar 

  10. Eccleshall S, Waliszewski M. The NICE recommendation for drug-coated balloons and its global impact. Ther Adv Cardiovasc Dis. 2015;9:87–94.

    Article  CAS  Google Scholar 

  11. Valgimigli M, Bueno H, Byrne RA, Collet JP, Costa F, Jeppsson A, Jüni P, Kastrati A, Kolh P, Mauri L, Montalescot G, Neumann FJ, Petricevic M, Roffi M, Steg PG, Windecker S, Zamorano JL, Levine GN, ESC Scientific Document Group, ESC Committee for Practice Guidelines (CPG), ESC National Cardiac Societies. ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: The Task Force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2018;39:213–60.

    Article  Google Scholar 

  12. Diehm N, Schneider H. Cost-effectiveness analysis of paclitaxel-coated balloons for endovascular therapy of femoropopliteal arterial obstructions. J Endovasc Ther. 2013;20:819–25.

    Article  Google Scholar 

  13. Pietzsch JB, Geisler BP, Garner AM, Zeller T, Jaff MR. Economic analysis of endovascular interventions for femoropopliteal arterial disease: a systematic review and budget impact model for the United States and Germany. Catheter Cardiovasc Interv. 2014;84:546–54.

    Article  Google Scholar 

  14. Kearns BC, Michaels JA, Stevenson MD, Thomas SM. Cost-effectiveness analysis of enhancements to angioplasty for infrainguinal arterial disease. Br J Surg. 2013;100:1180–8.

    Article  CAS  Google Scholar 

  15. Katsanos K, Geisler BP, Garner AM, Zayed H, Cleveland T, Pietzsch JB. Economic analysis of endovascular drug-eluting treatments for femoropopliteal artery disease in the UK. BMJ Open. 2016;6:e011245.

    Article  Google Scholar 

  16. Salisbury AC, Li H, Vilain KR, Jaff MR, Schneider PA, Laird JR, Cohen DJ. Cost-effectiveness of endovascular femoropopliteal intervention using drug-coated balloons versus standard percutaneous transluminal angioplasty: results from the IN.PACT SFA II Trial. JACC Cardiovasc Interv. 2016;9:2343–52.

    Article  Google Scholar 

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Pellegrini, D., Di Palma, G., Cortese, B. (2019). Cost/Effectiveness and Reimbursement Policies with Drug-Coated Balloons in Europe. In: Cortese, B. (eds) Drug-Coated Balloons . Springer, Cham. https://doi.org/10.1007/978-3-319-92600-1_21

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  • DOI: https://doi.org/10.1007/978-3-319-92600-1_21

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-92599-8

  • Online ISBN: 978-3-319-92600-1

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