July 17, 2019 — A new analysis published by The Sage Group LLC concludes that the all-cause cost of critical limb ischemia (CLI) exceeds $200 billion in the United States.
“CLI is an extremely expensive disease,” stated Mary L. Yost, president of The Sage Group, a research and consulting company specializing in peripheral vascular disease in the lower limbs — specifically chronic venous disease (CVD), peripheral artery disease (PAD), CLI, IC, diabetic foot ulcers (DFU) and the costs and consequences of amputation. “Inpatient hospitalizations account for the majority of costs with Medicare paying 73 percent of the bill.”
“Treatment with major amputation is one well-known factor that increases CLI costs,” observed Yost. “Amazingly, revascularization is underutilized in CLI patients. Between 25-33 percent of CLI patients are treated with primary amputation, which is more expensive than revascularization. The higher hospital costs of major amputation reflect more frequent and expensive complications, increased in-hospital mortality and more revision procedures,” she stated.
“However, there are many other factors that drive up CLI costs,” she continued. “Most of these, including amputation, are either modifiable or preventable.”
“Costs increase with disease severity,” Yost stated, “Rutherford 6 patients with gangrene incur higher costs than Rutherford 4 and 5 with rest pain and ulcers respectively. CLI treatment costs more than intermittent claudication (IC).”
“CLI-specific treatments are not the only factor increasing spending — cardiovascular events, such as heart attacks and strokes and related hospitalizations, add significantly to the economic burden,” Yost explained. “So does diabetes and diabetic hospitalizations.”
“Despite a high prevalence of cardiovascular disease and diabetes, cardiovascular risk factors and diabetes are suboptimally managed in CLI patients. This increases morbidity and mortality as well as costs, “ she continued.
“The tragedy is that earlier diagnosis of CLI and appropriate treatment, could save lives and limbs, as well as a tremendous amount of money,” concluded Yost.
CLI, or end-stage peripheral artery disease (PAD), is characterized by rest pain, ulcers and gangrene.
For more information: www.thesagegroup.us