Coronary Reactivity Testing Impact on ANOCA Healthcare Costs

Core Concepts

Coronary reactivity testing in patients with ANOCA can lead to cost savings by reducing downstream procedures and healthcare resource utilization.

Abstract

The content discusses the impact of performing coronary reactivity (CR) testing during angiography in patients with angina without obstructive coronary disease (ANOCA) on healthcare costs. Here is a breakdown of the key points:

• CR Testing Benefits:

  • CR testing can save money by limiting downstream procedures and healthcare resource utilization.
  • Differentiates endothelium-dependent from endothelium-independent coronary reactivity in ANOCA patients.
  • Helps in making more informed testing and management decisions.

• Cost Savings:

  • The study found that the CR testing group had significantly lower total healthcare costs over 2 years compared to the angiography-only group.
  • Reduced use of downstream imaging, interventional procedures, and other tests contributed to cost savings.

• Challenges and Recommendations:

  • CR testing programs are complex and require specialized expertise.
  • Despite guidelines recommending CR testing, its adoption in practice is limited due to cost and expertise requirements.
  • Authors recommend wider use of CR testing despite the challenges.

• Financial Impact:

  • The CR testing group had lower annual costs for procedures, imaging, and hospital services compared to the angiography-only group.
  • The study suggests that establishing a program of CR testing can lead to long-term cost benefits.

Stats

The difference in total healthcare costs between the CR testing group and the angiography-only group over 2 years averaged about $20,000.
The average annual cost for the angiography-only group was $37,804 compared to $13,679 for the CR testing group.
Costs for procedures in the angiography-only group averaged $5872 compared to $2104 in the CR testing group.
Costs for imaging in the angiography-only group averaged $2639 compared to $1426 in the CR testing group.
Annual total hospital services costs were significantly higher in the angiography-only group compared to the CR testing group.

Quotes

"The right thing to do is a vascular reactivity test to assess if there is any abnormality that can contribute to this patient’s symptoms and events." - Amir Lerman, MD
"Helping our patients get to the right diagnosis is the right thing to do. It will lead to better treatment recommendations, improved patient symptoms, improved patient confidence, and — it stands to reason — cost benefits in the long term.” - Matthew Tomey, MD

Key Insights Distilled From

Invasive Test May Cut Healthcare Costs Related to ANOCA

by Fran Lowry at www.medscape.com 07-17-2023

https://www.medscape.com/viewarticle/994448

Deeper Inquiries

How can healthcare systems overcome the challenges associated with implementing coronary reactivity testing programs?

Healthcare systems can overcome the challenges associated with implementing coronary reactivity (CR) testing programs by investing in specialized expertise and formalized technical training for operators. Motivated practitioners need to be trained to conduct CR testing effectively to produce valid results and limit procedural risks. Additionally, healthcare systems should ensure balanced reimbursement for CR testing to incentivize its widespread adoption. Collaborating with experts in the field and incorporating CR testing into guidelines can also help standardize its use and facilitate its integration into routine practice.

What are the potential drawbacks or limitations of relying heavily on coronary reactivity testing for ANOCA patients?

Relying heavily on coronary reactivity (CR) testing for patients with angina without obstructive coronary disease (ANOCA) may have drawbacks and limitations. One potential limitation is the complexity and cost associated with CR testing, which may deter healthcare providers from incorporating it into routine practice. Additionally, the need for specialized expertise and formalized technical training for operators to conduct CR testing accurately can be a barrier to its widespread implementation. Moreover, the lack of balanced reimbursement for CR testing may pose financial challenges for healthcare systems looking to adopt this diagnostic approach. Finally, the reliance on CR testing as the primary diagnostic tool for ANOCA patients may overlook other potential causes of symptoms, leading to misdiagnosis or delayed treatment.

How can the findings of this study impact the broader conversation around cost-effective healthcare practices?

The findings of this study can significantly impact the broader conversation around cost-effective healthcare practices by highlighting the potential cost savings associated with coronary reactivity (CR) testing for patients with angina without obstructive coronary disease (ANOCA). The study suggests that incorporating CR testing during angiography can lead to reduced downstream procedures, imaging, and other healthcare resource utilization, ultimately saving money in the long run. These cost-saving implications can inform discussions around the value of investing in CR testing programs to improve diagnostic accuracy, streamline patient management, and optimize healthcare resource allocation. By demonstrating the financial benefits of CR testing, this study can encourage healthcare systems to consider the long-term cost-effectiveness of implementing CR testing for ANOCA patients and potentially lead to its broader adoption in clinical practice.