Health is better than wealth, they say, but can you get there without money? Hospitals today face tough times as they attempt to balance top-notch patient care and dwindling resources. But while many say innovation will be the missing piece to the puzzle, will it be affordable?
This week, editorialists in Circulation questioned whether the demand for transcatheter aortic valve replacement (TAVR) will be too much for healthcare’s piggybank. In PARTNER cohort B, authors found costs for TAVR patients to be $52,000 more per patient compared with those treated conservatively. Additionally, they noted that TAVR added 1.6 years of life, but at a cost of $80,000 for an incremental cost-effectiveness ratio of $50,212 per life-year gained.
While these results provided a positive outlook, the editorialists went on to say that cohort A data painted a different picture. The editorialists said that if 100,000 aortic stenosis patients undergo treatment because of the new introduction of TAVR at an incremental cost of $80,0000, the bill would equate to $8 billion. So, while the outlook for the procedure may look cost-effective on the exterior, will it be affordable?
But while TAVR may be more than what is usually considered cost-effective in healthcare, many say that the improved quality of life and increased years it adds to very sick patients’ lives would outweigh the costs.
Another innovation—the medical home—was questioned in an analysis published in the Journal of the American Medical Association. Researchers found that clinics with higher scores as medical homes also had higher per-patient operating costs. While many would argue that the benefits outweigh the potential pitfalls, the authors said that use of the medical home would increase costs per-patient by $2.26 per month. This could translate into more than $500,000 in additional costs for a clinic that treats more than 18,000 patients.
The future of healthcare will remain a balancing act, and with all this talk of money, I feel compelled to mention the healthcare reform legislation. Will this be the last we hear on reform, or will it continue to be the topic of the hour?
Cardiovascular Business, associate editor