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Heart Drugs More Cost-Effective Than Angioplasty, Study Finds

By Alex Nussbaum

Sept. 24 (Bloomberg) — Artery-opening angioplasty adds $10,125 to a patient’s medical bill without significantly extending life or improving health for someone with chest pain, researchers said.

The figure, released today by the American Heart Association, is the latest finding that prompts some doctors to question the value of angioplasty procedures performed on more than 800,000 U.S. patients each year, at a cost of about $10 billion annually. Half of those are done to treat “stable” angina — temporary chest pains that can be treated with drugs, diet changes and exercise, the study said.

The procedure, in which a heart artery is unclogged with a balloon and propped open with a tiny tube called a stent, costs $34,843, including follow-up care. That compares with $24,718 for a regimen of anti-cholesterol medicines and lifestyle changes, researchers reported in the association’s journal, Circulation: Cardiovascular Quality and Outcomes.

“Although the difference narrows somewhat over time, it is never made up,” the researchers said in the study. While angioplasties may make sense for heart attack or severe blockages, “medical therapy alone offered better outcome at a lower cost” for those with stable coronary disease.

The results pose a challenge for device makers including Boston Scientific Corp., Abbott Laboratories,Johnson & Johnson and Medtronic Inc., whose revenue from drug-coated stents topped $4 billion in 2007. Sales of the $2,000 tubes have rebounded after falling 30 percent last year amid concerns the products triggered fatal blood clots.

Seven-Year Study

The study, funded by the U.S. and Canadian governments, is the third installment of a seven-year investigation dubbed Courage. Last year, researchers said drugs and lifestyle changes prevented deaths and heart attacks just as well as angioplasty. A report last month found both methods effective at easing chest pains after two years, though angioplasty offered some early advantages.

Most of the increased expense of angioplasty came from the operation itself, which cost $12,162 compared with $752 for the initial drug therapy. After that, follow-up care and medication expenses were about the same.

Angioplasties increased costs by $206,229 per year of extended life, said the researchers, led by William Weintraub, a cardiologist at Christiana Health Care System of Newark, Delaware….read more here…