Insurers may cut stent payouts

A new study suggesting that stents don't help non-emergency cardiac patients more than drugs could soon change how insurers reimburse for such treatments, observers say. The recent New England Journal of Medicine study, which looked at 2,287 non-emergency patients, found that angioplasty and stenting didn't save lives or prevent heart attacks, though it did reduce chest pain. Right now, roughly 50 to 80 percent of angioplasties are performed on non-emergency patients, with overall volume on the procedure at about 1 million per year. That's a big expense for insurers, considering that these procedures cost about $25,000 each--so some insurers are considering reimbursement cuts for what they now see as unnecessary stents. Cardiologists, meanwhile, are warning that the study only examined outcomes for cardiac patients with mild symptoms. While drugs may well work fine for these patients, those with worse symptoms may do better with stents, argues Dr. Bo Walpole, chairman of Saint Thomas Heart Institute in Nashville. "If angioplasty is delayed in patients with more serious problems, it could result in higher risk of death and permanent heart injury," he said.

To learn more about the stent controversy:
- read this article from The Tennessean

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