Peripheral Arterial Disease | Treatment Algorithms | Claims Data Analysis | US | 2014

With approximately two-thirds of peripheral arterial disease (PAD) patients being asymptomatic, drug treatment for PAD patients focuses largely on the symptomatic patients who have either intermittent claudication (IC) or critical limb ischemia (CLI). The goals of treatment in IC are twofold; the primary goal is to relieve the symptoms of this condition and improve patients’ daily functioning and quality of life, and the second goal is to reduce the risk of atherothrombotic events. Few drugs have been developed specifically for PAD treatment, and the choice of therapies has changed little in recent years. The treatment armamentarium still consists largely of therapies approved for coronary artery disease (CAD). For PAD, treatment typically consists of an antiplatelet agent, a statin, and an ACE inhibitor; vasoactive agents are also used for symptom relief in IC patients. In some cases, injectable prostaglandin analogues are often used as a last resort, or angioplasty or surgery may also be necessary. Using national patient-level claims data, this report analyzes physician adherence to the treatment guidelines by exploring the use of key therapies in the newly diagnosed and recently treated PAD patient populations. With respect to newly diagnosed patients, the report provides a quantitative analysis of treatment patterns and share by line of therapy, as well as progression between lines, duration of treatment on each line, and use of concomitant treatment. For recently treated patients, the report quantifies a drug’s source of business compared with its competitors and details which drugs precede others through an analysis of add-versus-switch patterns. Additional analyses explore persistency and compliance by brand.