Health technology assessment of treatment for peripheral arterial disease

Peripheral arterial disease (PAD) is a widespread cardiovascular disease that causes pain and reduces the patient’s ability to walk. The first objective of the thesis was to investigate current treatment patterns for PAD by identifying groups of PAD patients with different treatment needs according to their cardiovascular risk and their probability of undergoing invasive PAD treatment. As a result, three groups were identified. The second objective was to measure the quality of life of patients with PAD who receive different kinds of treatment, which showed a positive effect of all treatments, and to measure the costs of these treatments. Data from 245 Dutch PAD patients were used for these analyses. The final objective was to assess the cost-effectiveness of a new treatment strategy for PAD, rivaroxaban plus aspirin, by comparing the costs and health effects of the new treatment to those of existing treatments, treatment with aspirin or clopidogrel. The results of this analysis showed treatment with rivaroxaban plus aspirin was cost-effective overall but highlighted differences between patient groups.