Hospitalizations Heart Failure Fell 30% in a Decade; Largely a Result of Physician-Industry Collaboration Bringing Advances in HF Treatment

Over the past several years, critics have been critical of the pharmaceutical and medical device industry for making large profits and for certain rare cases of unethical behavior.  Many of these critics and their concerns have also spread to healthcare professionals who collaborate and work with industry, such as consultants, medical educators, and clinical researchers. 

These critics usually fail to acknowledge the tremendous benefits that the life sciences industry provides, and the significant amount of breakthroughs and progress and science that physician-industry collaboration creates, such as decreased rates of cancer and heart disease, improved treatments for chronic diseases such as diabetes, asthma, and hypertension, and increased life expectancy. 

However, as a recent article from USA Today noted, the life sciences industry is largely responsible for a significant decrease in hospitalizations of patients who experience heart failure.  Specifically, the article noted that, “hospital stays for heart failure fell a remarkable 30 percent in Medicare patients over a decade, the first such decline in the United States and forceful evidence that the nation is making headway in reducing the billion-dollar burden of a common condition.”

The authors of the study recognized that the declining hospital stays are largely associated with “specialized pacemakers and better use of medications such as ACE inhibitors that relax blood vessels, diuretics that prevent fluid buildup, digoxin that boosts heartbeat strength and beta blockers that ease strain on the heart.”  All of these tools are products created by physician-industry collaboration.

Additionally, Dr. Mariell Jessup, medical director of the Penn Heart and Vascular Center in Philadelphia, noted that other reasons for the decline in hospital stays include “healthier hearts, better control of risk factors like high blood pressure, and more patients treated in emergency rooms and clinics without being admitted to hospitals, said.

From 1998 to 2008, the rate fell from 2,845 hospitalizations per 100,000 Medicare beneficiaries to 2,007 per 100,000, according to research appearing in Wednesday’s Journal of the American Medical Association.  The study also found only a slight decline in deaths within a year of leaving the hospital, and progress lagged for black men.

The study included 55 million patients, the largest ever on heart failure trends.  According to lead author Dr. Jersey Chen of Yale University School of Medicine, “While heart failure hospitalizations have decreased nationally overall, certain populations haven’t seen the full benefit of that decrease.”

Heart disease and heart failure poses significant problems for Americans and our healthcare system.  More than 5 million Americans and 22 million people globally have heart failure.  Their hearts strain to pump blood because of damage, often from a heart attack or from high blood pressure.  Fluid backing up into the lungs can leave people struggling to breathe.

Heart disease contributes to heart failure.  Last week, federal health officials reported that the prevalence of self-reported heart disease in the U.S. decreased from nearly 7 percent to 6 percent from 2006 to 2010.

Fewer hospital stays saves Medicare a lot of money because heart failure is the most common cause of hospitalization in older patients.  But because of the innovation and advances of industry, in collaboration with government, physicians, and academic medical centers, we are beginning to see progress in our fight against heart failure and related problems and this progress is saving lives and money in our healthcare system.

For example, if the rate of hospitalizations had remained the same, there would have been 229,000 more heart failure hospital stays in 2008 at an additional cost to Medicare of $4.1 billion, Chen said.

Dr. Jessup called the research “extraordinary news,” and noted that, “Many efforts at changing the natural history of this disease seem to be having an effect, especially with the hospitalization rate.”  She still recognized however that it is “a very problematic disease.”

Although this research suggests tremendous advances, heart failure is still a challenge.  As the study pointed out, the proportion of patients who died within a year after being discharged fell, but only slightly, from about 32 percent to about 30 percent during the decade.  “The death rate is still unacceptably high,” said Dr. Mihai Gheorghiade of Northwestern University’s Feinberg School of Medicine in Chicago. Hospitals need to aggressively treat heart failure patients’ other ailments and immediately schedule follow-up care after discharge, said Gheorghiade, who wrote an accompanying editorial in the journal.

While this research is a sign of hope, the results indicate that physicians, healthcare professionals, continuing medical education (CME) providers, and all healthcare stakeholders need to continue educating and training physicians to realize the full potential of these benefits. 

As health care reform provisions begin to be implemented, calling for greater efficiency, cost effectiveness, and a strong emphasis on quality, it will be critical for healthcare providers, institutions, and medical schools to utilize the tools, training and education necessary to keep hospitalizations of heart failure patients down.  CME can be a strong tool for healthcare professionals to achieve these goals and to continue the success this study revealed.  Given that many of the reasons hospitalizations have decreased are directly attributed to the treatments and products industry has created, it only seems logical that industry support of CME, training, and education in areas of heart disease and heart failure would help providers and institutions further decrease hospitalization.