Trends in the Use of Cardiac Stents

Changing lifestyles and demographics across the world (i.e. aging population, increased middle class, rise in Chronic Diseases like obesity, CVD and diabetes) and increased access to medical care (i.e. more countries are working towards achieving universal healthcare), are all factors driving the global coronary stents market. Read more about the global market trends in this analysis blog by Ritza Suazo.

According to PR newswire, the coronary stents market alone is expected to reach a worth of about $ 9.5 bln (€ 8.7) worldwide by 2016, with North America and Europe accounting for about 41 and 29 percent of the market respectively. The Asia-Pac region will be one of the fastest growing markets within the next few years.

In recent years, the overuse of cardiac stents has spawned a wide array of studies and reports illustrating some of the negative results that can occur from this type of practice. According to Web MD news, several research articles in the U.S. have surfaced showing that as many as 2 out of 3 elective angioplasty procedures for patients with stable heart disease may not be needed. This is quite an astounding finding when one considers that in the U.S. alone, over seven million patients have undergone a cardiac stent procedure in the last decade.
An article by Pintas & Mullins Law Firm, estimates that stent overuse is costing the American healthcare system about $ 2.4 bln (€ 2.2 bln) per year.

Similar trends have been observed in China where according to an article by the Global Times, over 10 percent of patients are over-treated and about 1 out of 3 stents implanted are not needed. A case illustrated in this same article, described a patient that had 9 stents implanted, though a previous physician had prescribed only 1 to 2. In this case the patient spent $ 24.000 (€ 22.000) and still had his condition deteriorate after the procedure.

One of the main factors driving this type of practice in China is that health payment systems tend to reward physicians based on bulk or volume and not on actual quality of care. For example, a cardiologist receives no actual incentive to talk about procedure related risks and alternate forms of therapy, but they do receive payment for the actual implanting of a device.

In another article by the Xinhua news site in China, describes how many cardiologists are overusing stents because of the commissions earned for each stent implanted (e.g. stents cost up to 20,000 Yuan (€ 2,968) each and commissions can reach 2000 Yuan (€ 296) per implant).

As illustrated by the many cases that have recently come to light, this issue has put focus on the costliness, waste and patient vulnerability surrounding the implant of cardiac stents.

A series of measures have recently been enforced to change this type of practice. For example, an article by the Global Times, published the following counter-measures that have been put in place by the Chinese government:

  • The Chinese government has started requiring bulk central purchasing for a variety of medical items including stents. This will reduce prices and commission rates.
  • Hospitals need to conduct group consultations when implanting more than 3 stents.
  • The Heilongjiang provincial health authority has set forth regulations requiring physicians to send detailed reports when implanting more than 3 stents to a local quality control authority. This will help curb the amount of unnecessary stents implanted.

Similarly, a Medscape article has listed the following recommendations to improve the situation in the U.S.:

  • Encourage standardized reporting for interventional procedures
  • Encourage standardized analysis and interpretation for test results
  • Promote and improve procedures related to informed consent
  • Actively encourage patient knowledge and understanding of the benefits and risks related to PCI
  • Provide the general public and professional education on these topics.

For both the U.S. and China, it will be interesting to observe if such measures will have a significant impact on market growth rates in the coming few years.

For further quantitative information on the healthcare system and the macroeconomic climate for over 40 countries, please look into our Business intelligence platform containing volumes of 620 surgical procedures in 13 specialisms.

About Ritza Suazo

Researches and creates Clinical Pathways and Country Deep Dive Reports at TforG. With almost a decade of experience in Clinical Market research she also manages and recruits the TforG advisory board. She graduated with a double major in psychology and international business management from Stony Brook University in New York and continues to apply her experience in research specializing in the US, UK, Spain and South American Markets.