HUENNEKENS: Obama effectiveness proposal

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By Scott Huennekens

COMMENTARY:

The West Coast is far removed from East Coast politics, geographically. We may be known for our surf and sun, but with Arnold Schwarzenegger leading our state and Nancy Pelosi leading Congress, it's hard for Californians to stray too far from the political pulse.

And, as we are a leading state in the areas of patient care, health care research and medical-device development, last week's visit by President Obama's team to Los Angeles brought together key stakeholders with a vested interest in repairing the ailing health care system.

It's difficult to take a back seat in the health reform debate. Everyone wants a say. When Mr. Obama proposed setting aside $1.1 billion for comparative effectiveness research, diagnostic and imaging companies from Washington to Los Angeles had opinions.

Most medical-device manufacturers fear that Mr. Obama's intentions to fund this research may prove that their technologies fail to provide enough value to justify their cost. The industry worries that this research may show imaging technologies such as MRI, CTA and CTs are often overused and lack enough information to diagnose and treat patients appropriately, a threat to both the patient and the health care system.

While most medical device manufactures weigh the impact of comparative effectiveness on their market, a few companies, including Volcano Corp., support the president's investment in medical breakthroughs and innovation to reduce our reliance on procedures that have become standard despite their high cost and lack of efficacy.

The United States needs to focus on treating the right patient at the right time with the right method to lower health care costs, improve patient outcomes and foster research and development.

It may not be the most popular opinion to have in our industry, but with health care spending representing an unsustainable 17 percent of our gross domestic product, our country must invest in research to find faster, less expensive solutions to common medical problems without creating more regulatory and reimbursement hurdles that often slow adoption.

Diagnostic tools not only improve patient care but also lower health care costs. For example, intravascular ultrasound (IVUS) and fractional flow reserve (FFR) technologies enable doctors to see inside vessels and assess blockages, helping them make more informed decisions on whether a patient would be effectively treated with a $15,000 interventional outpatient procedure (or simply medication) rather than an unnecessary $47,000 bypass procedure with a long recovery time that keeps a patient from his family and job. Using the current, popular technologies, it is easy to see how less efficient treatments for heart disease, one of the most expensive, chronic conditions, begin to add up.

Despite clinical data, cost-saving technologies such as IVUS and FFR are not widely used in the United States, where doctors are compensated for treatments executed rather than patient outcomes. Comparatively, these technologies are more widely used in universal health care systems in Europe and Japan, which enjoy lower adverse-event rates and lower overall health care expenditures (around 10 percent of the GDP).

Though the United States dominates the medical-device industry and is the driver of innovation, the industry is forced to test devices in Europe because of regulatory constraints in the United States. These regulatory burdens also delay access to new medical technology, available in Europe two to three years ahead of the U.S. market.

Finally, if more patients can be treated with less expensive, minimally invasive procedures rather than costly, highly invasive surgeries with long hospital stays and recovery times, it's a win for the entire health care system. We must ensure that our policies do not slow the development and research jobs that can speed our transition to less costly, less invasive procedures.

We welcomed Mr. Obama's health care team to California and hope fruitful discussion continues about the innovative technologies being developed within the state that already are improving patient outcomes and reducing health care costs. We strongly believe the funding Mr. Obama has proposed for comparative effectiveness research will illuminate the positive impact these technologies will have on health care spending. Increasing reimbursement for technologies such as IVUS and FFR may cost a couple hundred million dollars now, but it will save the health care system billions down the road.

Dialogue and collaboration among health care companies, physicians and Congress on all ideas related to reforming the health care system are the keys to success. We may not always see eye to eye, but we must foster that sharing of knowledge to improve the quality and affordability of care for our nation's citizens.

Scott Huennekens is president and chief executive officer of Volcano Corp., a health care company in California focused on developing diagnosis and treatment technology.