So in the latest of the stent wars a new study suggests that Medicare has been saving money as drug-eluting stents have replaced by-passes. This of course is music to the ears of J’n’J & Boston Scientific — not to mention the odd invasive cardiologist. And they’ve been getting, shall we say, a touch aggressive about marketing their product–here’s JSK’s great entry on DTC stent marketing at Health Populi. (By the way, Jane’s blog is really good. and is keeping those old veterans of the HC blogging world amongst us on our toes!)
However, it’s not clear to me whether the interpretation of this study hasn’t ignored two things in the context of the stent world.
The first is that earlier this year COURAGE essentially showed that medical management is better than stenting (or at least no worse). The other issues is the timing. What we really need to know is the value over the long-term. The data in this study is not old enough to know what happens in the long term–and of course in Medicare we’re all paying over the long term.
But of course four years ago in what is still one of my favorite posts on THCB, a Stanford study showed that in the long-run stents ended up costing considerably more than CABG’s — which is why I said then that we should dump the stent and have a by-pass!