"Innovation is the central issue in economic prosperity"
At a presentation during the annual Cardiovascular Research Technologies (CRT) conference last week, Dr. Peter J. Fitzgerald from Stanford said that the economic downturn has left clinical implications on medical practice, particularly by preventing new technologies from emerging.
“There is a significant decrease in capital, which can serve as kerosene for innovation. Without dollars and support, new technologies cannot really come to fruition,” he said.
In the Stanford region alone, healthcare funding has dropped 52 percent, and federal financing for research is down almost 50 percent as compared with 1976. Fitzgerald noted that innovation is slowing quickest in the U.S.
In other news, a cost analysis of the SAPPHIRE trial showed that in patients at a high risk for carotid surgery, upfront costs for carotid artery stenting (CAS) with embolic protection are more expensive, but the procedure is more cost effective in the long run when compared with carotid endarterectomy (CEA).
However, while the adoption of CAS may be widespread within this high risk patient cohort, CAS adoption has been sluggish within the population of patients who are at a standard risk for surgery, despite large outcome trials like CREST that have shown procedural benefits, David J. Cohen, MD, of Saint Luke’s Mid America Heart and Vascular Institute, told Cardiovascular Business News. These low adoption rates stem from the lack of reimbursement, but once payment is expanded, it could help increase CAS procedural adoption for this patient population.
Additional news this week from JAMA showed that meta-analyses under-report conflicts of interests that are previously reported in randomized controlled trials. This has the potential to compromise the reader's understanding and appraisal of the evidence.
Lastly, a commentary that evaluated the benefits of a pay-for-performance initiative in the U.K., found that the P4P system, which integrated a team-based approach to care and provided financial incentives to help reach evidence-based outcomes, may need work.
In fact, while the model encouraged team work and the use of health IT to record outcomes, overall the researchers wrote that the framework needs improvement as it is not perfect in terms of improving the quality of care.
As we move toward a time when innovation within the device industry is booming, the economic downturn has the potential to impact procedural adoption and possibly outcomes. To support the upcoming shift toward accountable care organizations, CMS and FDA must help drive these initiatives of quality and continue to help advance innovation.
On these topics or others please feel free to contact me.