Plain balloon angioplasty with or without bare-metal stenting versus drug-coated balloon angioplasty with or without bare-metal stenting versus primary drug-eluting stenting in patients requiring femoropopliteal, with or without infrapopliteal, endovascular revascularization for chronic limb-threatening ischaemia: BASIL-3 within-trial health economic analysis
Year: 2025
Type: article
Abstract: BACKGROUND: The BASIL-3 trial demonstrated that patients with chronic limb-threatening ischaemia secondary to femoropopliteal disease who were randomized to plain balloon angioplasty (PBA) ± bare-metal stenting (BMS), drug-coated balloon angioplasty (DCBA) ± BMS, or drug-eluting stenting (DES) had similar clinical outcomes. Herein, the in-trial health economic analysis is presented. METHODS: Cost-utility analysis (CUA) and cost-effectiveness analysis (CEA) were conducted from the perspective of the UK National Health Service (NHS) and Personal Social Services Research Unit. Patient-level resource use and health outcome data were collected from the BASIL-3 trial during 2-7 years of follow-up and were utilized to estimate incremental cost-effectiveness ratios expressed as a cost per amputation-free life-year and per quality-adjusted life-year (QALY). EQ-5D-5L was used to generate participant QALYs at baseline and during follow-up. RESULTS: In the CUA, DCBA was associated with slightly lower NHS costs (-£250.71 (95% c.i. -£4630.34 to £3652.10)), but slightly lower QALY gains (-0.007 (95% c.i. -0.116 to 0.097) QALYs) when compared with PBA. When compared with PBA, DES was less costly (-£724.52 (95% c.i. -£4975.04 to £2631.57)) and resulted in an additional 0.048 (95% c.i. -0.060 to 0.148) QALYs. CONCLUSION: In BASIL-3, the probability of DCBA and of DES being cost-effective at £20 000 per QALY was 52% and 76% respectively. At a higher willingness-to-pay threshold (£30 000 per QALY) DES may be cost-effective and further research is required to explore the economic case.
Source: British journal of surgery
DOI: 10.1093/bjs/znaf274
Authors: Mishal Javed, Jesse Kigozi, Catherine A Moakes, Gareth R Bate, Jack A Hall, Jon J Deeks, Lisa Kelly, Lewis Meecham, Andrew W Bradbury, Matthew A Popplewell, the BASIL-3 Investigators, A Ganeshan, H Zayed, R Davies, A Saratzis, I Chetter, S Butterfield, S Goode, J Metcalfe, P Mezes, S Hobbs, N Goyal, J Patel, M Caruna, T Rashid, N Das, N Arya, P Chong, S Habib, R White, G Antoniou, A Davies, A Rogers, S Dindyal, N Arestis, G Weir, P Davey, R Das, G Stansby, R Eifell, J Asquith, L Wijesinghe, A Chaudhuri, J Sathianathan, N Thayur, F Ahmad
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $5,007
OpenAlex ID: W7133528136