Cost-effectiveness of exercise therapy in patients with intermittent claudication: Supervised exercise therapy versus a 'go home and walk' advice

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Abstract

Objectives: The Exercise Therapy in Peripheral Arterial Disease (EXITPAD) study has shown supervised exercise therapy (SET) to be more effective regarding walking distance and quality of life than a 'go home and walk' advice (WA) for patients with intermittent claudication. The present study aims to assess the cost-effectiveness of SET versus WA. Patients and methods: Data from the EXITPAD study, a 12-month randomised controlled trial in 304 patients with claudication, was used to study the proportion of costs to walking distance and quality of life. Two different incremental cost-effectiveness ratios (ICERs) were calculated for SET versus WA: costs per extra metre on the treadmill test, and costs per quality-adjusted life year (QALY). QALYs were based on utilities derived from the EuroQoL-5 dimensions (EQ-5D). Results: Mean total costs were higher for SET than for WA (3407 versus 2304 Euros), mainly caused by the costs of exercise therapy. The median walking distance was 620 m for SET and 400 m for WA. QALYs were 0.71 for SET and 0.67 for WA. All differences were statistically significant. The ICER for cost per extra metre on the 12-month treadmill test was 4.08. For cost per QALY, the ICER was 28693. Conclusion: At a willingness-to-pay threshold of 40 000 per QALY, SET likely is a cost-effective therapeutic option for patients with claudication. © 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

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Van Asselt, A. D. I., Nicolaï, S. P. A., Joore, M. A., Prins, M. H., & Teijink, J. A. W. (2011). Cost-effectiveness of exercise therapy in patients with intermittent claudication: Supervised exercise therapy versus a “go home and walk” advice. European Journal of Vascular and Endovascular Surgery, 41(1), 97–103. https://doi.org/10.1016/j.ejvs.2010.06.024

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