Comparative cost analysis of Eluvia™ versus Zilver ® PTX ® in treating femoropopliteal peripheral artery disease utilizing real-world data

Aim: To compare the hospital-based costs among patients with femoropopliteal artery (FPA) disease treated with Eluvia™ versus Zilver ® PTX ® drug-eluting stents using a large real-world USA hospital database. Materials & methods: This retrospective study included adults in the Premier Healthcare Database who underwent lower extremity FPA endovascular revascularization with Eluvia or Zilver PTX between 1 April 2019 and 31 March 2022. Total hospital-based costs during the index procedure and cumulative 1- and 2-year post-discharge follow-up were compared using multivariable generalized linear models adjusted for age, sex, race and baseline chronic limb-threatening ischemia (CLTI) status. Prespecified subgroup analyses were conducted by care setting (hospital inpatient and hospital outpatient) and among patients with chronic kidney disease (CKD) and CLTI. Results: A total of 7208 patients were included, comprising 4218 treated with Eluvia and 2990 treated with Zilver PTX. Patients treated with Eluvia had a higher prevalence of several comorbidities, including congestive heart failure and CKD. Unadjusted mean hospital-based index procedure costs were similar between groups (Eluvia, $28,631 vs Zilver PTX, $28,359; difference, -$272; p = 0.7233). After adjustment, mean index procedure hospital-based costs did not differ significantly between treatment groups ($30,031, p = 0.8491). However, Eluvia was associated with lower adjusted cumulative hospital-based costs at the 1-year (difference, $4,017; p = 0.0066) and 2-year (difference, $6250; p = 0.0021) follow-up. Similar associations were observed in the hospital inpatient and CKD subgroups, whereas no statistically significant differences were observed in the CLTI subgroup. Conclusion: Across patients undergoing femoropopliteal endovascular revascularization, Eluvia was associated with significantly lower post-discharge cumulative hospital-based follow-up costs than Zilver PTX while index procedure costs were comparable. These findings reflect hospital-based costs captured within participating hospitals and do not include medication costs or costs of care received outside the Premier Healthcare Database; therefore, they should not be interpreted as total healthcare costs.