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Am Health Drug Benefits. 2015 Oct;8(7):366-74.

Evaluating the Expected Costs and Budget Impact of Interventional Therapies for the Treatment of Chronic Venous Disease.

Author information

Dr Carlton is Associate Director, Xcenda, Palm Harbor, FL.
Dr Mallick is Senior Director, BTG International, West Conshohocken, PA.
Dr Campbell is Manager, Xcenda, Palm Harbor, FL.
Mr Raju is Manager, Xcenda, Palm Harbor, FL.
Dr O'Donnell is Benjamin Andrews Chair of Surgery Emeritus, Tufts Medical Center, Boston, MA.
Dr Eaddy is Vice President, Xcenda, Palm Harbor, FL.



Chronic venous disease is a common disorder in the United States. The manifestations of chronic venous disease include varicosities and related sequelae that are frequent contributors to the morbidity and high costs associated with the disease. The interventional treatment options for chronic venous disease have expanded greatly in recent years and include various surgical and vein ablation techniques. Polidocanol injectable foam (also known as polidocanol endovenous microfoam 1%), a chemical ablation agent, is the most recent entrant to the market.


To evaluate the expected patient-level total treatment costs and health plan-level budgetary impact of polidocanol injectable foam compared with the currently available interventional treatment options from a third-party US payer perspective.


A Microsoft Excel-based budget impact model was designed to compare the costs of polidocanol injectable foam with other interventional treatments (ie, laser ablation, radiofrequency ablation, surgery, and multimodality treatment). The model included drug acquisition, medical procedure, administration, additional treatment, and disease progression costs. The treatment patterns and rates of additional treatment were incorporated from a recent retrospective claims analysis for established treatment modalities and from the clinical trials for polidocanol injectable foam. The model estimates the 1-year total estimated costs and the health plan budget impact assuming an 8-week treatment time frame.


The total expected 8-week treatment costs were $2165 for polidocanol injectable foam, $1827 for endovenous laser ablation, $2106 for radiofrequency ablation, $2374 for surgery, and $2844 for multimodality treatment. The initial treatment costs were higher for surgery and multimodality treatment compared with polidocanol injectable foam and were lower for endovenous laser ablation and radiofrequency ablation treatments. Polidocanol injectable foam is projected to have a relatively small budget impact ($0.01 per member per month) at an initial 5% market share.


Polidocanol injectable foam offers an alternative to other interventional options for the treatment of varicose veins and is projected to have a relatively small budget impact. From a health plan perspective, this drug is likely to have a relatively low budget impact as it becomes more widely used.


budget impact model; chronic venous disease; endovenous laser ablation; multimodality treatment; polidocanol injectable foam; radiofrequency ablation; varicose veins


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