Cardiac stenting has emerged as a leading technology for the treatment of coronary artery disease. This analysis seeks to explore the current market trends linked to cardiac stents in the United States. We utilized both a systematic literature review and a nationally representative data set (the Healthcare Cost and Utilization Project National Inpatient Sample) in an attempt to report the current trends of cardiovascular market. Results revealed an increase in coronary revascularization procedure and a correlating decrease in coronary artery bypass graft surgery (CABG) discharges. Although the medical device industry has shown growth and stability over the past decade, the true cost effectiveness of many of its products, including drug eluting stent (DES) vs. bare metal stent (BMS) vs. biodegradable stents, remains difficult to evaluate. Demographic characteristics will increase the overall use of stents while the challenges (e.g. new taxes) that the medical device industry faces in the context of the Affordable Care Act (ACA) of 2010 remain in question. Few research efforts have offered probable solutions to these obstacles, but their effectiveness has yet to be proven.
HahnRHeathGChangM. Cardiovascular disease risk factors and preventive practices among adults – United States, 1994: A behavioral risk factor atlas. MMWR CDC Surveill Summ1998; 47: 35–69.
5.
WeisfeldtMZiemanS. Advances in the prevention and treatment of cardiovascular disease. Health Aff (Millwood)2007; 26(1): 25–25.
6.
Goldman D, Shang B, Bhattacharya J, et al. Consequences of health trends and medical innovation for the future elderly. Health Aff (Millwood) 2005; 24(Suppl 2): W5R5–17.
7.
CaliffRMHarringtonRAMadreLKPetersonEDRothDSchulmanKA. Curbing the cardiovascular disease epidemic: aligning industry, government, payers, and academics. Health Aff (Millwood)2007; 26(1): 62–74.
8.
BergmanRNeremR. The cardiovascular technology industry: Past, present, and future. Cardiovasc Eng Technol2010; 1(1): 4–9.
9.
TamburinoCCapodannoD. Evolution of stents: Past, present and future. Expert Rev Cardiovasc Ther2009; 7(5): 443–446.
LutzenkirchenJZimmermannRPreocaninT. An attempt to explain bimodal behaviour of the sapphire c-plane electrolyte interface. Adv Colloid Interface Sci2010; 157(1–2): 61–74.
13.
MarroquinOCSelzerFMulukutlaSR. A comparison of bare-metal and drug-eluting stents for off-label indications. N Engl J Med2008; 358(4): 342–352.
14.
CurfmanGDMorrisseySJarchoJADrazenJM. Drug-eluting coronary stents—promise and uncertainty. N Engl J Med2007; 356(10): 1059–1060.
15.
SmithSNewhouseJPFreelandMS. Income, insurance, and technology: Why does health spending outpace economic growth?Health Aff (Millwood)2009; 28(5): 1276–1284.
16.
NewhouseJ. Medical care costs: How much welfare loss?J Econom Perspect1992; 6(3): 3–21.
17.
RettigRA. Medical innovation duels cost containment. Health Aff (Millwood)1994; 13(3): 7–27.
EisenbergM. Drug-eluting stents: The price is not right. Circulation2006; 114(16): 1745–1745.
20.
TuJVBowenJChiuM. Effectiveness and safety of drug-eluting stents in Ontario. N Engl J Med2007; 357(14): 1393–1402.
21.
RoccaHPBLKaiserCBernheimA. Cost-effectiveness of drug-eluting stents in patients at high or low risk of major cardiac events in the Basel Stent KostenEffektivitäts Trial (BASKET): an 18-month analysis. Lancet2007; 370(9598): 1552–1559.
22.
KaiserCBrunner-La RoccaHPBuserPT. Incremental cost-effectiveness of drug-eluting stents compared with a third-generation bare-metal stent in a real-world setting: Randomised Basel Stent Kosten Effektivitäts Trial (BASKET). Lancet2005; 366(9489): 921–929.
23.
BagustAGraysonADPalmerNDPerryRAWalleyT. Cost effectiveness of drug eluting coronary artery stenting in a UK setting: Cost–utility study. Heart2006; 92(1): 68–68.
24.
LigthartSVlemmixFDendukuriNBrophyJM. The cost-effectiveness of drug-eluting stents: A systematic review. Can Med Assoc J2007; 176(2): 199–205.
25.
RyanJCohenD. Are drug-eluting stents cost-effective?: It depends on whom you ask. Circulation2006; 114(16): 1736–1736.
26.
NallamothuBKSaintSEagleKA. Coronary artery bypass grafting in octogenarians: Clinical and economic outcomes at community-based healthcare facilities. Am J Manag Care2002; 8(8): 749–755.
27.
BrickerDLDaltonMLJr. Cardiac surgery in the community hospital. Ann Thorac Surg1974; 17(5): 450–458.
28.
KongDFEisensteinELSketchMHJr. Economic impact of drug-eluting stents on hospital systems: A disease-state model. Am Heart J2004; 147(3): 449–456.
29.
DorseyERde RouletJThompsonJP. Funding of US biomedical research, 2003-2008. JAMA2010; 303(2): 137–143.
30.
DorseyERThompsonJPCarrascoM. Financing of U.S. biomedical research and new drug approvals across therapeutic areas. PLoS One2009; 4(9): e7015–e7015.
31.
MosesHIIIDorseyEMathesonDHMThierSO. Financial anatomy of biomedical research. JAMA2005; 294(11): 1333–1333.
32.
NeumannPJRosenABWeinsteinMC. Medicare and cost-effectiveness analysis. N Engl J Med2005; 353(14): 1516–1522.
33.
NexonDUblSJ. Implications of health reform for the medical technology industry. Health Aff (Millwood)2010; 29(7): 1325–1329.
BrindisRDehmerG. Continuous quality improvement in the cardiac catheterization laboratory: Are the benefits worth the cost and effort?Circulation2006; 113(6): 767–767.
36.
AckerlyDCValverdeAMDienerLWDossaryKLSchulmanKA. Fueling innovation in medical devices (and beyond): venture capital in health care. Health Aff (Millwood)2009; 28(1): w68–75.
37.
HahnRWKloversKBSingerHJ. The need for greater price transparency in the medical device industry: An economic analysis. Health Aff (Millwood)2008; 27(6): 1554–1559.
38.
Medical Device Manufacturers Association. Broad Coalition Urges Cogressonal Leaders to Repeal Medical Device Tax. 2011; http://www.medicaldevices.org/node/1039 (accessed October 3, 2011).
