The Sage Group

THE SAGE GROUP Supports the “Stop P.A.D.” Petition Drive to Expand Medicare Coverage to Test Patients for Peripheral Arterial Disease

ATLANTA, September 15, 2009–(Business Wire)–In recognition of National P.A.D. Awareness Month, Mary L. Yost, President of THE SAGE GROUP recommends that patients, relatives, and the medical community join the campaign to increase access to a simple noninvasive test to diagnose peripheral arterial disease (abbreviated P.A.D. or PAD).

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.

“Asymptomatic does not mean that the disease is benign. PAD is not just a leg problem,” declared Ms. Yost. Within 5 years, 50% of patients will experience a heart attack or stroke; 30% will be fatal. PAD, also known as peripheral vascular disease (PVD), is characterized by a reduction of blood flow to the lower limbs due to atherosclerosis. In the severe stages of PAD (critical limb ischemia or CLI) blood flow is so inadequate that ulcerations and gangrene occur. Once PAD has progressed to CLI, the risks of limb loss and mortality increase. At six months, approximately 20% of those with CLI will die; another 35% will experience amputation. THE SAGE GROUP estimates that approximately 160,000 PAD-related amputations are performed annually in the U.S. “The tragedy is that early diagnosis and treatment could eliminate many of these amputations,” declared Yost.

Ms. Yost noted, “As the nation debates healthcare reform, it is important to keep in mind that early diagnosis is a key factor in reducing the costs of chronic diseases, such as PAD.”

If diagnosed in the early stages, PAD patients can be treated with the 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 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. The inability of a large percentage of these amputees to live independently adds significantly to the total cost burden,” stated Yost.

“Since the ABI test is generally not performed on asymptomatic PAD patients, significant numbers remain undiagnosed until they suffer a heart attack or develop ulcers and gangrene. In our opinion this needlessly increases overall costs,” Ms. Yost observed. “We have estimated that a 25% reduction in the number of amputations could save $2.9 billion in healthcare expenditures. Based on today’s procedure costs and long term care costs this is probably a conservative number,” she continued.

THE SAGE GROUP estimates that 16-17 million U.S. citizens currently have PAD and 2.2 to 2.7 million of them suffer from critical limb ischemia.

Additional information about PAD and vascular diseases can be found at the nonprofit Vascular Disease Foundation site at
To sign the petition, go to and complete the online form.

THE SAGE GROUP, an independent market research and consulting company, specializes in atherosclerotic disease in the lower limbs, specifically PAD (Peripheral Arterial Disease), CLI (Critical Limb Ischemia) and ALI (Acute Limb Ischemia).

For additional information visit

Mary Yost, 404-520-6652