Cost-Effectiveness of Drug-Coated Balloon Angioplasty Versus Conventional Balloon Angioplasty for Treating Below-the-Knee Arteries in Chronic Limb-Threatening Ischemia: The SINGA-PACLI Trial.

Journal Article (Journal Article)

PURPOSE: Drug-coated balloon angioplasty (DCBA) has been studied as a potentially superior option compared to conventional percutaneous transluminal angioplasty (PTA) in treating below-the-knee (BTK) arteries in chronic limb-threatening ischemia (CLTI). The aim of this study is to examine the cost-effectiveness of DCBA versus PTA in BTK arteries based on a randomized controlled trial. MATERIAL AND METHODS: A prospective economic study was embedded in a randomized controlled trial of 138 patients with CLTI. Resource use and health outcomes were assessed at baseline, and at 3, 6 and 12 months post-intervention. Costs were calculated from a societal perspective and health outcomes measured using quality-adjusted life years with probabilistic sensitivity analysis performed to account for subject heterogeneity. RESULTS: Compared with participants randomized to receive PTA, participants randomized to DCBA gained an average baseline-adjusted quality-adjusted life years (QALYs) of .012 while average total costs were USD$1854 higher; this translates to an incremental cost-effectiveness ratio (ICER) of US$154,500 additional cost per QALY gained. However, the estimate of ICER had substantial variance with only 48% of bootstrap ICERs meeting a benchmark threshold of US$57,705 (the average gross domestic product (GDP) per capita of Singapore). CONCLUSION: The use of DCBA in BTK arteries in CLTI patients was not cost-effective compared with PTA. LEVEL OF EVIDENCE: 2, Randomized trial.

Full Text

Duke Authors

Cited Authors

  • Sivapragasam, N; Matchar, DB; Zhuang, KD; Patel, A; Pua, U; Win, HH; Chandramohan, S; Venkatanarasimha, N; Chua, JME; Tan, GWL; Irani, FG; Leong, S; Tay, KH; Chong, TT; Tan, BS

Published Date

  • November 2022

Published In

Volume / Issue

  • 45 / 11

Start / End Page

  • 1663 - 1669

PubMed ID

  • 35237860

Electronic International Standard Serial Number (EISSN)

  • 1432-086X

Digital Object Identifier (DOI)

  • 10.1007/s00270-022-03073-7


  • eng

Conference Location

  • United States