The Sage Group

In Recognition of National Peripheral Artery Disease (PAD) Awareness Month, THE SAGE GROUP Comments on the Costs and Consequences of the Disease

ATLANTA, Sept 8, 2014 (BUSINESS WIRE)—According to THE SAGE GROUP LLC, peripheral artery disease afflicts 18 million Americans costing the U.S. between $164 and $290 billion annually.

“PAD costs more than other major, chronic diseases, including diabetes and coronary disease,” stated Mary L. Yost, President of THE SAGE GROUP. “Amazingly, the bill for PAD is two to three times the dollar amount spent on all cancers in the U.S.”

Elaborating on the reasons for these high costs, Yost explained, “The majority of the costs are inpatient (62%-87%) and PAD-specific treatmenst are only one factor driving up spending. Cardiovascular events, such as heart attacks and strokes, and related treatments accouint for over 40% of costs, adding significantly to the total.”

“Other ‘hidden costs’ increase the total, so that the real economic burden of PAD is actually even higher than $164-$290 billion,” Yost elaborated. “Two of these hidden costs ischemic diabetic foot ulcers (DFU) and functional decline, have not typically been considered ci=ontributors o

“For example, diabetic foot ulcer patients with PAD are significantly more expensive to treat,” Ms. Yost explained, “According to our estimates, PAD/DFU cost $61 billion, which we believe should be added to the economic cost of PAD. A similar argument can be made for the costs associated with fuctional decline, impaired mobility and inability to work or perform the daily tasks of living.”

“Despite the significant national bill, PAD remains underestimated, underdiagnosed, undertreated and under-researched,” Yost continued. “This highly prevalent, costly and deadly disease continues to be largely ignored resulting in unnecessary mortality, morbidity and amputations.”

“As the nation grapples with a spiraling healthcare bill, it is important to keep in mind that early diagnosis is a key factor in reducing the costs of chronic diseases, such as PAD,” Ms. Yost observed.

PAD can be diagnosed by a simple, noninvasive test. This inexpensive test, known as the ankle-brachial index (ABI), is a cost-effective method to detect disease in asymptomatic patients. Although Medicare currently offers testing for patients with symptoms, PAD is most commonly asymptomatic. According to THE SAGE GROUP, 75% is asymptomatic.

“Asymptomatic does not mean the disease is benign. PAD is not just a leg problem; it is also a heart and a brain problem,” declared Ms. Yost. “Asymptomatic patients are hospitalized at similar rates and cost as much as symptomatic patients, not for leg treatments but for heart attacks and strokes.”

If diagnosed in the early stages, PAD patients can be treated with appropriate lifestyle modifications and drug therapies to reduce the risks of heart attack and stroke; exercise therapy to reduce the pain of claudication; or if blockages are more severe, with minimally invasive revascularization technologies.

“However, if the disease is not diagnosed until critical ischemia (CLI) occurs, interventional therapy is more costly. If gangrene is so severe that the limb cannot be salvaged, the patient must undergo amputation, the most costly procedure,” Yost elaborated.

“Amputation is not only extremely undesirable from the patient’s viewpoint it is socially undesirable in terms of costs. According to our estimates, CLI amputations cost $25 billion,” she continued.

PAD, also known as peripheral vascular disease (PVD), is characterized by a reduction of blood flow to the lower limbs due to atherosclerosis. The most commonly recognized symptom is intermittent claudication (IC) or pain in the leg when walking, which disappears at rest.

In the most severe stages of PAD (critical limb ischemia) blood flow is so inadequate that rest pain, ulcers and gangrene occur.

Additional information about PAD and amputation prevention can be found at two nonprofit sites: the Save A Leg Save A Life Foundation at and My Leg My Choice at

THE SAGE GROUP, a research and consulting company, specializes in atherosclerotic disease in the lower limbs, specifically PAD, IC, CLI, Acute Limb Ischemia and ischemic DFU. The most recent research focuses on quantifying the economic and social costs of PAD, CLI and amputation.

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Mary Yost, 404-520-6652