Procedure costs and outcomes associated with pharmacologic management of peripheral arterial disease in the department of defense

This study was undertaken to determine if differences existed between pharm acologic treatments of peripheral arterial disease (PAD) with respect to PA D-related costs and health care outcomes in the United States Department of Defense health care system. We performed a retrospective review of hospita l and prescription data to explore the effects of at least 90 days of aspir in, pentoxifylline, papaverine, or dipyridamole on 4 PAD-related outcomes: number of PAD-related invasive procedures (INV), number of PAD-related exam ination procedures (EXM), number of PAD-related hospitalization days (HDAYS ), and cost of PAD-related procedures (COST) during 5 years. A covariate re presenting the number of PAD-related hospitalizations before the study peri od was used to attempt to control for severity of disease state. General li near models were used in the analyses. A statistically significant differen ce was seen between treatment groups for a linear combination of INV, EXM, HDAYS, and COST when controlling for past PAD-related hospitalizations (P < 0.014). A statistically significant relationship existed between treatment , groups and INV (P < 0.041). The pentoxifylline treatment group had a stat istically significant higher covariate-adjusted mean INV compared with the aspirin treatment group (P < 0.043). Also, PAD-related past hospitalization s were significantly related to EXM (P < 0.006). Our results appear to supp ort the use of aspirin as a preventive treatment in PAD compared with pento xifylline or dipyridamole.