Drug-Coated Balloons Cost Less Than PTA Over 3 Years for Femoropopliteal PAD; Bare-Metal and Drug-Eluting Stents Fail Cost-Effectiveness Threshold

Economic model of femoropopliteal peripheral artery disease treatment: paclitaxel drug-coated balloons averaged $8,406/patient over 3 years vs. $9,151 for angioplasty alone — cost-saving. Bare-metal stents ($13,325) and drug-eluting stents ($13,054) exceeded $150,000/QALY, faili…

• Modeling study using 2023 Medicare national-average reimbursement rates; inputs derived from published literature, not a prospective trial or real-world claims dataset — results depend heavily on assumed target lesion revascularization and bailout stent rates.
• Four FDA-approved drug-coated balloon devices (IN.PACT Admiral, Stellarex, Lutonix, Ranger) showed comparable 3-year costs of $8,027–$8,804 per patient; incremental QALYs gained vs. PTA were modest across all strategies (0.0035–0.0054).
• Key limitation: model-based economic analysis with literature-derived inputs; does not capture real-world heterogeneity in patient selection, lesion complexity, or payer mix beyond Medicare.

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