A COST-UTILITY ANALYSIS OF LASER-ASSISTED ANGIOPLASTY FOR PERIPHERAL ARTERIAL OCCLUSIONS

Despite the perception of many people that lasers represent the cuttin g edge of high-technology medicine, this form of medical technology ha s been subject to relatively little rigorous evaluation. This dearth o f research relates particularly to economic evaluation, where there ha ve been few attempts to justify the high cost of laser equipment. This paper details an economic evaluation of the use of laser technology a s a secondary adjunct to angioplasty to treat peripheral arterial occl usions. Using data from a range of sources, including a published rand omized trial, a cost-utility model is developed to estimate the costs and benefits of the laser, relative to standard angioplasty. The best available data indicate a cost-effective role for the laser, but impor tant areas of uncertainty exist, including the laser's secondary recan alization rate, which has been estimated on the basis of limited numbe rs of patients. This uncertainty suggests that further research is req uired before widespread diffusion of the laser for use in this clinica l context.