Nov 16, 2019

Heart study casts further doubt on stents, bypass

Photo: GUILLERMO ARIAS/AFP via Getty Images

A new study suggests stents and bypass operations may be unnecessary or premature for people with severe but stable heart disease.

Why it matters: "The results challenge medical dogma and call into question some of the most common practices in heart care," the AP reports.

Our thought bubble: Stents had already been considered unnecessary for many patients, and this study raises serious questions about whether invasive procedure like stents and bypass surgery should be used instead of basic drugs for stable patients with heart problems.

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Health industry expects little change from heart study

How a stent works. Photo: BSIP/Universal Images Group via Getty Images

A new federal study said stents and bypass surgery are no more effective than drugs for treating blocked arteries, but the health care industry and its investors aren't banking on major changes to heart care as a result.

The big picture: Placing stents and performing bypasses are two of the most common operating room procedures. Science continues to say we don't need to be doing them so often, but overhauling that standard of care isn't easy — in part because hospitals and device makers make a lot of money from them.

Go deeperArrowNov 19, 2019

Researchers criticize $225,000 annual price of Pfizer's new heart-failure drug

Illustration: Rebecca Zisser/Axios

Some of the researchers who helped develop a new heart-failure drug are criticizing its high price, Bloomberg reports.

The intrigue: Pfizer, which makes the drug, says that it's targeted at a small population, justifying the high price. But critics say that the condition isn't that rare, setting up Pfizer to reap in a fortune from the medication.

Go deeperArrowNov 20, 2019

Surprise bills often hit in emergencies

Reproduced from Kaiser Family Foundation; Chart: Axios Visuals

People who are in the middle of a health crisis often are at an especially high risk for surprise medical bills, according to previously unreleased data from the Kaiser Family Foundation.

The big picture: The new data underscore the importance of a legislative solution to help patients who are powerless to protect themselves.

Details: People having surgery or receiving mental health and substance abuse treatment at an in-network hospital are the most likely to experience a surprise bill from an out-of-network provider.

  • Among people with employer-based insurance, out-of-network charges were 50% higher among heart-attack victims than for other diagnoses.
  • 21% of women undergoing mastectomies experienced out-of-network provider charges.

My thought bubble: It’s hard to imagine many patients who are so prepared and insurance-savvy that they could protect themselves from an out-of-network bill in the middle of a heart attack.

Why it matters: It doesn’t take a headline-sized bill to wreak havoc on family budgets.

  • Half of the American people say they would have to borrow money or go into debt to pay a $500 medical bill, or wouldn’t be able to pay it at all.
  • Unexpected medical bills are the public’s top health cost concern, ahead of deductibles, premiums, drug costs, and even paying the rent or the mortgage.
  • People with major medical conditions and chronic illnesses are most likely to experience problems paying their medical bills.

The bottom line: Congress is torn between two competing ideas solving this issue and settling payment disputes between insurers and providers. Each plan has its own implications for premiums and industry negotiations, but for patients, just getting a fix is the most important thing.