Abstract No. 522 - Evaluating the expected budget impact and cost-effectiveness of interventional therapies used in the treatment of chronic venous disease

Abstract

Purpose Varicose veins (VV) and resulting sequelae contribute to morbidity assoc w/chronic vein disorders (CVD), impacting QOL and resulting in ~ $1B/yr. Total cost minimization and budget impact evaluation assessed 8-wk diff between Varithena ® (polidocanol endovenous microfoam [PEM]) vs alternate tx for VV in US from a 3rd-party payer perspective. Materials and Methods Tx options incl PEM, EVLA, RFA, surgery, and multi-modality tx, defined >1 tx on same day. Total cost components incl (wholesale) drug acquisition costs , pmt for professional (CMS physician fee schedule) and institutional (Hospital Outpatient Prospective Pmt System) services related to initial intervention, weighted for each modality, plus expected costs of addl interventions, weighted by corresponding rate of addl interventions, within 8-wk time frame. Evidence on rate of addl interventions for PEM came from 2 pooled, phase 3 studies, and for other modalities from US retrospective claims analysis of pts w/VV. Budget impact was modeled for hypothetical 1M member plan w/evidence-based assumptions: 76% adults, 6% chronic venous insufficiency prevalence, and 31% rate of interventional tx among pts w/dx VV, and derived in terms of total and per-member-per-month (PMPM) expenditure change given 5% initial PEM market share. Results PEM was expected to cost $2,165 (incl $615 (28%) for addl tx) compared to $2,374 (14% for addl tx) for surgery, $2,106 (32% for addl tx) for RFA, $1,827 (38% for addl tx) for EVLA, and $2,844 (26% for addl tx) for multi-modality tx. Budget impact for 1M member hypothetical health plan was $87k or $0.01 PMPM. Conclusion PEM is expected to have slightly lower addl tx rates than and cost ~ same as RFA and EVLA (performed alone) but be less costly than surgery and multi-modality tx (≥2 interventions on same day) for VV tx. Adding PEM to the formulary for a health plan is ~ budget neutral. Exp 8-wk Costs, Tx Options Comparator Initial tx costs Addtl tx rate Expected addtl tx cost Total expected costs PEM $1550 39.7% $615 $2165 EVLA $1130 52.4% $697 $1827 RFA $1430 40.0% $676 $2106 Surgery $2049 17.9% $325 $2374 Multi-modality tx $2107 34.9% $737 $2844