New treatments for congestive heart failure could be too costly

Two new treatments have arrived to mitigate the effects of congestive heart failure (CHF), a growing problem in the United States. But their cost may be prohibitive, according to a new report by the Institute for Clinical and Economic Review (ICER) and the California Technology Assessment Forum.

The report concluded that the new CardioMEMS stent developed by St. Jude Medical and the new drug Entresto, developed by Novartis, could add billions of dollars a year to the nation's healthcare costs.

Congestive heart failure is usually linked to chronic conditions such as diabetes and coronary heart disease, both of which have been growing in the U.S. dramatically in recent years. 

The CardioMEMS device would cost about $17,750 apiece, according to the study. It has shown to decrease CHF-related hospitalizations by a moderate amount, although that may also be because study subjects also received close nurse supervision. The report concluded that it would cost about $1.6 billion a year to place the stent in about 563,000 patients--less than 10 percent of the population suffering from CHF. The reported concluded that the stent would have to be priced at around $7,600 to be cost-effective.

Users of Entresto also reported fewer CHF-related hospitalizations and a higher quality of life. The drug is presumed to cost about $4,560 per patient per year. However, the study concluded that it would cost about $3.5 billion a year to provide the drug to the CHF patient population that would most benefit from it. The report concluded that the drug would need to be priced at around $3,800 per year for it to actually provide a cost benefit in relation to its clinical effectiveness.

Drug costs have been an increasingly thorny problem for the U.S. healthcare system, as prices continue to rise even for old-line medications that have been on the market for decades. A recent study by Avalere Health has concluded that the Medicare and Medicaid programs will spend about $50 billion over the next decade just to cover 10 new drugs. And spending on specialty drugs rose by more than 20 percent last year alone.

"We need to figure out if there are ways to make them more affordable," ICER President Steven Pearson told Kaiser Health News.

To learn more:
- read the report (.pdf)
- check out the Kaiser Health News article

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