OBJECTIVES: Lower-limb peripheral arterial disease (PAD) is a common manifestation of systematic atherosclerosis leading to significant morbidity and mortality. In Korea, drug-eluting stent (DES) implantation is the standard of care for treatment of PAD, however, different DES products are associated with different rates of total lesion revascularisation (TLR) and subsequent healthcare resource use. This study aimed to estimate the financial savings realised when selecting a paclitaxel-eluting DES (Eluvia) over a paclitaxel-coated DES (Zilver PTX) for treatment of PAD in Korea at the population-level.

METHODS: A 5-year budget-impact analysis was conducted to estimate the cost savings associated with the use of Eluvia compared with Zilver-PTX from the Korean National Health Insurance System perspective. Two-year efficacy and safety data were sourced from the IMPERIAL randomised controlled trial which compared Eluvia and Zilver PTX in patients with lower-limb PAD. Episodic cost and epidemiology data relating to endovascular percutaneous and surgical interventions, DES prices and volume, were collected from Korea’s Health Insurance Review and Assessment (HIRA) service, using relevant K-ICD10 codes; and were validated externally. Yearly growth in procedures was informed by historical trends. Trial results at 12-24 months were applied to each year’s incident population (with no projections) and associated costs in order to calculate the number of TLRs and hospital readmissions.

RESULTS: The analysis estimated a total of 8,416 patients with lower-limb PAD will be treated with DES from 2020-2024. Assuming 100% of these patients will be treated with Eluvia compared with Zilver PTX, potential savings of ₩5,489 million (~USD 4.5 million) was estimated to the Korean payer. Potential savings were primarily driven by the fewer TLRs with Eluvia compared with Zilver PTX (1,190 vs. 2,035) over the 5-year period.

CONCLUSIONS: The Eluvia DES is a cost-saving option for lower-limb PAD treatment in Korea, owing to the reduced TLRs and hospital readmissions compared with Zilver PTX.