Big money goes around the world"

Kaitlyn Dmyterko, staff writer

“Big money goes around the world. Big money give and take. Big money done a power of good. Big money makes mistakes,” sang the rock band Rush. As Rush sang in Big Money, the medical industry is responsible for a large chunk of U.S. cost expenditures. Most funds are put toward researching new techniques and technologies to improve cardiovascular care. However, some studies have shown that while these costs may be necessary and beneficial, they also have the potential to be avoided.

In fact, a study published this week in Circulation showed that by 2030 the costs to treat heart disease will triple. An American Heart Association research panel said that the idea of a more personalized approach to medicine should be undertaken to help prevent cardiovascular (CV) disease. By 2030, the panel estimated that 116 million people in the U.S. will be diagnosed with some form of heart disease whether it is high blood pressure, coronary heart disease, heart failure or stroke.

In a similar study exploring the costs associated with cardiovascular care, Canadian researchers found that if Canada had put in place a more restrictive policy to monitor the administration of ARBs, the country could have saved almost $77 million in 2006.

The costs of CV drugs in Canada alone skyrocketed by more than 200 percent between 1996 and 2006 and the researchers urged that ARBs that ACE inhibitors could be a safe, less-expensive alternative.

In other news, an FDA advisory panel recommended (7-3 vote) that carotid artery stenting (CAS) should be expanded to cover those at a standard risk for adverse events while undergoing surgery.

The push was based off the results of the CREST trial which has produced a large amount of fodder in the industry about which procedure is better for stroke prevention, CAS or carotid endarterectomy (CEA). The new FDA guidelines will allow CAS to be covered more broadly by CMS. However, a recent Journal of Vascular Surgery study has also showed that CAS may be significantly more expensive that CEA, $19,000 versus $12,000 per procedure.

Lastly, a study this week in JAMA outlines the benefits of primary stroke centers and how they reduced mortality by almost 3 percent compared with non-designated stroke centers. In a commentary, Dr. Mark Alberts urged that a “tiered system” including comprehensive stroke centers and primary stroke centers could improve future stroke care.  These tactics could lead to better care and potentially reduce stroke readmissions, which lead to high costs.

“Big money got a heavy hand. Big money take control,” sang Rush. Costs associated with the medical industry are hefty; however, some may have the potential to be prevented with more restrictive policies or replacing procedures with others that are just as safe and less expensive.

Feel free to contact me with any questions or comments.

Kaitlyn Dmyterko
kdmyterko@cardiovascularbusiness.com