This economic analysis combined PEERLESS trial event probabilities with published inputs to model lifetime costs and quality-adjusted life years for intermediate-risk pulmonary embolism from a US health-system perspective. Large-bore mechanical thrombectomy was modeled as less costly and more effective than catheter-directed thrombolysis, with $5850 net monetary benefit at $120,000 per quality-adjusted life year. During PE management, modeled savings were $4755 per patient, with 0.009 quality-adjusted life years gained, largely reflecting resource utilization. No incremental long-term cost or quality-adjusted life-year differences were modeled between groups.
The model suggests an economic advantage for large-bore mechanical thrombectomy over catheter-directed thrombolysis in this US setting. It does not establish a survival benefit or determine the preferred intervention for individual patients.
Study limitation: Lifetime estimates depend on published resource-use, cost, and long-term event inputs rather than exclusively on trial observations.
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