SS06 - How Vascular Disease Costs More than an Arm and the Leg: Annual Chronic Limb Ischemia Cost Per Capita Approaches and May Exceed Annual Per Capita Costs of Top Cancers in the United States.

Objectives: Chronic Limb ischemia (CLI) poses significant mortality, morbidity, and economic burdens which are under-appreciated. Costs of the top 4 cancers by new diagnosis (breast, prostate, lung, and colon/ rectal) are well documented and offer a valuable comparison. This study aims to compare the annual per capita cost (APC) of CLI to these cancers.

Methods: A targeted literature review was performed to identify and extract relevant economic data. Each study utilized Medicare payments to analyze cost. Based on limited data, we obtained the APC of CLI for patients undergoing both intervention in the year 2011. We used the consumer price index to adjust for inflation to the year 2020. We utilized the Surveillance, Epidemiology, and End Results (SEER) database which reported from 2007-2013 inflation adjusted initial, follow up, and last year of life costs for breast cancer, prostate cancer, lung cancer, and colorectal cancer for the year 2020. APC data was absent. We estimated the APC by taking a mean of the following 3 values: initial, follow up, and last year of life costs. Survival rates are well over 3 years for these cancers; our calculated APC is a likely overestimate. Bar graphs were constructed. We compared the APC of CLI to the “APC” of each of the four cancers. We then compared the initial, follow up, and last year of life costs with each cancer to the APC of CLI.

Results: For the year of 2011, the estimated APC of CLI in patients undergoing endovascular procedures was $58,218.98 for the year 2020 after adjusting for inflation. For patients undergoing open surgery, the adjusted APC was $57,633.28. The SEER database identified the initial, follow up, and last year of life costs ($31,689.43, $3,206.68, $68,943.34); ($68,293.30, $12,388.60, $110,247.80); ($60,266.49, $5,658.79, $99,783.90); ($28,108.50, $2,602.60, $74,227.30) for breast, prostate, lung, and colorectal respectively. Calculated APCs for the years 2007-2013 were $34,613.15 for breast cancer, $34,979 for prostate cancer, $63,643 for lung cancer, and $55,236.39 for colorectal cancer for the year 2020 after adjusting for inflation in Figure 1. The APC of CLI exceeded the calculated APC of breast, prostate, and colorectal cancer in Figure 2.

Conclusions: Within the limitations of our data, our study suggests that the APC of CLI approaches and may exceed the APC of common cancers. This is likely secondary to complications and medical comorbidities associated with CLI. CLI interventions, research, and prevention offer a potential effective avenue for healthcare cost reduction.