{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T05:25:11Z","timestamp":1767677111215,"version":"3.48.0"},"reference-count":26,"publisher":"BMJ","issue":"2","funder":[{"name":"GoreTex"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,12,19]]},"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the budget impact of progressive replacement of standard polytetrafluoroethylene (PTFE) grafts by heparin-bound PTFE (Propaten) for below-the-knee (BTK) bypass in patients with critical limb ischaemia (CLI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>From a review of the scientific literature, we calculated a theoretical BTK primary patency for Propaten grafts. Using the French hospital expenditure database (PMSI), we retrospectively estimated a rehospitalisation rate for standard PTFE grafts. From these data, a model was created to assess the budget impact of a progressive replacement from standard PTFE grafts to Propaten grafts over a 5-year horizon. We performed an univariate sensitivity analysis to assess the robustness of our results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>French National Health Insurance (FNHI) perspective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participant<\/jats:title>\n                    <jats:p>Patients with CLI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Budget impact analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Data extraction from the PMSI revealed that 656 patients were treated with PTFE grafts in 2011 in French public hospitals for a BTK bypass. Assuming a 2-year survival rate of 76.8%, observed reinterventions rate for standard PTFE grafts at 24 months from the PMSI was 35.1%. The mean rehospitalisation cost was \u20ac10 689. The budget impact analysis based on these data found a net cumulative 5-year payer budget reduction of \u20ac112 420 in favour of Propaten, under the assumption of a 75.6% primary patency for Propaten grafts for a projected population of 3215 patients of which 801 received a Propaten graft.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our budget impact analysis showed a positive impact on the national health insurance budget of the replacement of standard PTFE grafts by Propaten grafts for BTK bypass in patients with CLI in France. This supports the enactment of a reimbursement policy by the FNHI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-017320","type":"journal-article","created":{"date-parts":[[2018,2,28]],"date-time":"2018-02-28T10:56:17Z","timestamp":1519815377000},"page":"e017320","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Budget impact analysis of heparin-bonded polytetrafluoroethylene grafts (Propaten) against standard polytetrafluoroethylene grafts for below-the-knee bypass in patients with critical limb ischaemia in France"],"prefix":"10.1136","volume":"8","author":[{"given":"Simon","family":"Vergnaud","sequence":"first","affiliation":[{"name":"Innovation Cell, Partnership and Innovation Department, Directorate of Medical Affairs and Research, CHU de Nantes, Nantes, France"},{"name":"Department of Medical Information, CHU de Nantes, Nantes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Val\u00e9ry-Pierre","family":"Riche","sequence":"additional","affiliation":[{"name":"Innovation Cell, Partnership and Innovation Department, Directorate of Medical Affairs and Research, CHU de Nantes, Nantes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Tessier","sequence":"additional","affiliation":[{"name":"Innovation Cell, Partnership and Innovation Department, Directorate of Medical Affairs and Research, CHU de Nantes, Nantes, France"},{"name":"SPHERE (EA4275) - Biostatistics, Clinical Research and Pharmaco-Epidemiology, Nantes University, Nantes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Mauduit","sequence":"additional","affiliation":[{"name":"Department of Medical Information, CHU de Nantes, Nantes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrien","family":"Kaladji","sequence":"additional","affiliation":[{"name":"Service de Chirurgie Vasculaire, CHU Nantes, l\u2019institut du Thorax, Nantes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yann","family":"Gou\u00ebffic","sequence":"additional","affiliation":[{"name":"Service de Chirurgie Vasculaire, CHU Nantes, l\u2019institut du Thorax, Nantes, France"},{"name":"Laboratoire de Physiopathologie de la R\u00e9sorption Osseuse, Inserm-UN UMR-957, Nantes, France"},{"name":"Facult\u00e9 de m\u00e9decine, Universit\u00e9 de Nantes, Nantes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,2,28]]},"reference":[{"key":"2025121514365083000_8.2.e017320.1","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.ejvs.2006.09.024","article-title":"Inter-society consensus for the management of peripheral arterial disease (TASC II)","volume":"33 Suppl 1","author":"Norgren","year":"2007","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2025121514365083000_8.2.e017320.2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31828b82aa"},{"key":"2025121514365083000_8.2.e017320.3","doi-asserted-by":"publisher","DOI":"10.1016\/S1078-5884(11)60014-2"},{"key":"2025121514365083000_8.2.e017320.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(02)75332-9"},{"key":"2025121514365083000_8.2.e017320.5","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2000.108634"},{"key":"2025121514365083000_8.2.e017320.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2011.01.021"},{"key":"2025121514365083000_8.2.e017320.7","doi-asserted-by":"crossref","first-page":"1300","DOI":"10.1002\/bjs.10246","article-title":"Five-year outcomes following a randomized trial of femorofemoral and femoropopliteal bypass grafting with heparin-bonded or standard polytetrafluoroethylene grafts","volume":"103","author":"Lindholt","year":"2016","journal-title":"Br J Surg"},{"key":"2025121514365083000_8.2.e017320.8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"2025121514365083000_8.2.e017320.9","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1016\/j.jvs.2011.05.046","article-title":"A multicenter comparison between autologous saphenous vein and heparin-bonded expanded polytetrafluoroethylene (ePTFE) graft in the treatment of critical limb ischemia in diabetics","volume":"54","author":"Dorigo","year":"2011","journal-title":"J Vasc Surg"},{"key":"2025121514365083000_8.2.e017320.10","first-page":"339","article-title":"Heparin-bonded expanded polytetrafluoroethylene graft for infragenicular bypass: five-year results","volume":"50","author":"L\u00f6sel-Sad\u00e9e","year":"2009","journal-title":"J Cardiovasc Surg"},{"key":"2025121514365083000_8.2.e017320.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2005.09.006"},{"key":"2025121514365083000_8.2.e017320.12","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/j.ejvs.2009.11.034","article-title":"Renal insufficiency is independently associated with a distal distribution pattern of symptomatic lower-limb atherosclerosis","volume":"39","author":"Wasmuth","year":"2010","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2025121514365083000_8.2.e017320.13","unstructured":"Statistics from the French Medical Information Agency (ATIH). ScanSant\u00e9. http:\/\/www.scansante.fr\/. (cited 8 Jan 2016)."},{"key":"2025121514365083000_8.2.e017320.14","doi-asserted-by":"publisher","DOI":"10.1053\/j.semvascsurg.2010.06.001"},{"key":"2025121514365083000_8.2.e017320.15","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(98)70315-5"},{"issue":"3 Suppl","key":"2025121514365083000_8.2.e017320.16","first-page":"24","article-title":"Amputation rate and mortality in elderly patients with critical limb ischemia not suitable for revascularization","volume":"24","author":"Martini","year":"2012","journal-title":"Aging Clin Exp Res"},{"key":"2025121514365083000_8.2.e017320.17","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-012-0494-x"},{"key":"2025121514365083000_8.2.e017320.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2013.08.2291"},{"key":"2025121514365083000_8.2.e017320.19","unstructured":"Dorrucci V , Griselli F , Petralia G , et al . Heparin-bonded expanded polytetrafluoroethylene grafts for infragenicular bypass in patients with critical limb ischemia: 2-year results. 2008:49\u20132."},{"key":"2025121514365083000_8.2.e017320.20","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.21974"},{"key":"2025121514365083000_8.2.e017320.21","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.001811"},{"key":"2025121514365083000_8.2.e017320.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2007.07.025"},{"key":"2025121514365083000_8.2.e017320.23","first-page":"407","article-title":"Results with heparin bonded polytetrafluoroethylene grafts for femorodistal bypasses","volume":"47","author":"Peeters","year":"2006","journal-title":"J Cardiovasc Surg"},{"key":"2025121514365083000_8.2.e017320.24","first-page":"425","article-title":"Infrainguinal ePTFE vascular graft with bioactive surface heparin bonding. First clinical results","volume":"46","author":"Walluscheck","year":"2005","journal-title":"J Cardiovasc Surg"},{"key":"2025121514365083000_8.2.e017320.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2008.12.009"},{"key":"2025121514365083000_8.2.e017320.26","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1016\/j.jvs.2016.03.414","article-title":"Heparin-bonded expanded polytetrafluoroethylene femoropopliteal bypass grafts outperform expanded polytetrafluoroethylene grafts without heparin in a long-term comparison","volume":"64","author":"Samson","year":"2016","journal-title":"J Vasc Surg"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-017320","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T22:37:00Z","timestamp":1765838220000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-017320"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2]]},"references-count":26,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2018,2,28]]},"published-print":{"date-parts":[[2018,2]]}},"alternative-id":["10.1136\/bmjopen-2017-017320"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-017320","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2018,2]]}}}