The Sage Group

According to THE SAGE GROUP, the National Bill for the Treatment of Peripheral Artery Disease (PAD) Exceeds $14 Billion

ATLANTA, June 2, 2010 (BUSINESS WIRE)—Speaking at the New Cardiovascular Horizons (NCVH) meeting in New Orleans, Mary L. Yost, President of THE SAGE GROUP, released results of a new analysis of the macroeconomic costs of PAD.

In 2007 the costs of treating PAD patients in the inpatient setting were $14.3 billion. “Significantly, over 70% of these costs and 65% of discharges represented treatment at the most severe stages of the disease, critical limb ischemia (CLI),” stated Ms. Yost.

Average charges increase with disease severity so that gangrene treatment costs $65,898 versus $46,789 for rest pain and $39,304 for intermittent claudication. “Given the intensity of therapies required to treat more ischemic limbs and the fact that these patients have multiple severe comorbidities, it is not surprising that average treatment costs are higher for gangrene than intermittent claudication,” Ms. Yost observed.

“What is surprising is that the total number of discharges for the most severe forms of lower limb disease far exceeded the number of those for intermittent claudication (IC),” continued Ms. Yost.

“In addition, within the three specific diagnostic codes for CLI the number of discharges increased with severity; there were almost twice as many discharges for gangrene as there were for rest pain. Unfortunately, in-hospital mortality also increased with disease severity; mortality for gangrene discharges was 4.24% versus 0.83% for rest pain and 0.3% for IC,” she observed.

Comparing CLI costs and discharges with acute myocardial infarction (AMI) and stroke, average CLI inpatient charges exceeded those of AMI and were almost twice as high as for stroke. However, reflecting a significantly higher number of discharges (over 3 times for AMI and 4 times for stroke) the national bill for heart attack and stroke exceeds that of CLI.

About the Cost Analysis

The data for the costs of PAD were derived from an analysis of the 2007 Hospital Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) database employing the ICD-9 principal diagnostic codes for PAD. The unit of analysis is the hospital discharge, not a patient. A patient admitted 3 times in one year would be counted as three discharges.

Hospital charges (the amount billed for the entire stay) were employed as the measure of inpatient macroeconomic costs. However, charges understate the total economic cost because physician fees are not included. In addition, the absence of outpatient treatments, pharmaceutical costs, nursing home charges and home healthcare charges as well as the indirect costs of lost employment understate the true macroeconomic cost.


THE SAGE GROUP, a research and consulting company, specializes in atherosclerotic disease in the lower limbs, specifically PAD (Peripheral Artery Disease), CLI (Critical Limb Ischemia) and ALI (Acute Limb Ischemia). The most recent research focuses on PAD and diabetic foot ulcers (DFU).

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