Dr Robert A Lookstein (Icahn School of Medicine, NY, US) discusses the budget impact model for the IN.PACT® AV access trial from the perspective of the US and DE health systems. 

Filmed on location at the Leipzig Interventional Course 2020. 

Interviewer: Ashlynne Merrifield
Videographer: Natascha Wienand

Transcript Below :

Question 1 : Can you tell us about the budget model for the IN.PACT AV Access Global study ?

So, the budget model for the IN.PACT AV Access Global study looked at the outcomes at 12 months, specifically with regards to primary patency of the target lesion treated, as well as freedom from clinically-driven target lesion revascularization. We took those models and extended those out using re-intervention as a constant hazard, from 12 months out to 36 months. What we then did is we took those models out to 36 months and incorporated those into the fiscal payment data for the German healthcare system for 2020, as well as the American healthcare system for fiscal year 2020. And what we found was that there was significant cost savings, specifically per patient. It was over 1000 euros seen in savings at the 12 month follow-up period, and over 3300 euros in savings at the three year period. Similar savings were seen in the American model, where just over $1000 of savings were seen at the 12 month point, and over $3300 in savings were seen at the 36 month part. This has dramatic implications for any public healthcare system that's managing patients on hemodialysis. So, in a very conservative model, if you look at solely 5000 interventions performed using the impact drug-coated balloon, in the German healthcare delivery system for patients with end-stage renal disease, you would see up to $16 million worth of savings out to three years, solely by transforming those small interventions over to IN.PACT AV access. In the American model, again, we were very conservative with our estimates. If only one in two patients had an IN-PACT drug-coated balloon, used instead of plain balloon angioplasty, our savings at three years was over $400 million for the entire Medicare beneficiary population suffering from end-stage renal disease. So, the results are very profound, and I think they should have a major implication and major impact on the healthcare delivery systems moving forward, about how physicians, hospitals, and healthcare delivery systems should be incentivized to use this powerful technology.