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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.

What they're saying: Cardiologists and researchers across the world widely praised the trial's methods and results, and heart care leaders have said the diminished value of stents and bypass surgery would be incorporated into standard care guidelines.

Yes, but: "Established practices die hard, especially when there is a substantial culture, mindset and financial structure reinforcing that behavior," said Vikas Saini, a cardiologist and president of the Lown Institute, who said the trial's results matched up with decades of research.

  • Mike Mahoney, CEO of Boston Scientific, one of the largest makers of stents in the world, told investors in October that if the trial presented a dim view of stenting, the company would lose, at most, $40 million in sales next year as physicians reconsider their practices — a blip within the company's $4 billion cardiovascular business.
  • Physicians surveyed by investment bank SVB Leerink said stent procedures would drop at most 10%, and that could be temporary as heart patients develop more aggressive symptoms and ask for surgery later.
  • "We don't expect a major change in behavior, but do believe many physicians are more likely to opt for conservative therapies going forward," medical device analysts with JPMorgan wrote in a research note.

The bottom line: The prices of individual stents range anywhere from several hundred to several thousand dollars, and the surgeries tack on tens of thousands more for hospitals, which have been pretty dedicated to keeping their beds full whenever possible.

  • "Much of what we do lacks evidence; and even when evidence mounts that a policy is ineffective, our political system often caters to invested stakeholders who benefit from it," health economist Austin Frakt recently wrote in the New York Times.

Go deeper

House passes $1.9 trillion COVID relief package

Photo: Screenshot via C-SPAN

The House approved President Biden's $1.9 trillion COVID relief package on a 219-212 vote early Saturday morning, sending it to the Senate for a possible rewrite before it gets to Biden's desk.

The big picture: The vote was a critical first step for the package, which includes $1,400 cash payments for many Americans, a national vaccination program, ramped-up COVID testing and contact tracing, state and local funding and money to help schools reopen.

8 hours ago - Health

Biden says it's "not the time to relax" after touring vaccination site

President Biden speaking after visiting a FEMA Covid-19 vaccination facility in Houston on Feb. 26. Photo: Mandel Ngan/AFP via Getty Images

President Biden said Friday that "it's not the time to relax" coronavirus mitigation efforts and warned that the number of cases and hospitalizations could rise again as new variants of the virus emerge.

Why it matters: Biden, who made the remarks after touring a vaccination site in Houston, echoed CDC director Rochelle Walensky, who said earlier on Friday that while the U.S. has seen a recent drop in cases and hospitalizations, "these declines follow the highest peak we have experienced in the pandemic."

Updated 8 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Annelise Capossela/Axios

  1. Health: Most COVID-19 survivors can weather risk of reinfection, study says — "Twindemic" averted as flu reports plummet amid coronavirus crisis
  2. Vaccine: FDA advisory panel endorses J&J COVID vaccine for emergency use — About 20% of U.S. adults have received first vaccine dose, White House says — New data reignites the debate over coronavirus vaccine strategy.
  3. Economy: What's really going on with the labor market.
  4. Local: All adult Minnesotans will likely be eligible for COVID-19 vaccine by summer — Another wealthy Florida community receives special access to COVID-19 vaccine.
  5. Sports: Poll weighs impact of athlete vaccination.