Enhanced External Counterpulsation Is Cost‐Effective in Reducing Hospital Costs in Refractory Angina Patients

Abstract

Background: Enhanced external counterpulsation (EECP) is effective in the treatment of refractory angina, a condition suffered by 1.7 million Americans. Declining cardiovascular mortality and appropriate use criteria may further increase this number. Hypothesis: EECP is hypothesized to be cost-effective in reducing hospitalizations in refractory angina patients. Methods: The data used in this analysis were collected in phase II of the International EECP Patient Registry (IEPR-II). Data were collected on changes in Canadian Cardiovascular Society functional class, Duke Activity Status Index, and number of hospitalizations in the 6 months prior to EECP and in the 6-and 12-month intervals following EECP. Estimates of the changes in annual cost of all-cause hospitalization before and after EECP therapy were calculated by the product of the differences in hospitalization rates in the 6-month interval before and after EECP treatment and estimated hospitalization and physician charges after subtracting the average cost of EECP. Results: Data for 1015 patients were analyzed. Hospitalization occurred in 55.2% of patients, an average of 1.7 ± 1.4 hospitalizations/patient, in the 6-month period before 35 hours of EECP; and in 24.4%, an average of 1.4 ± 1.0 hospitalizations/patient, during the 6-to 12-month period after EECP. The average hospitalization and physician charge in the US was $17 995, and the average EECP cost was $4880, yielding an annual cost savings/patient of $17 074. Conclusions: Treatment of refractory angina patients with EECP resulted in improvement in angina and functional class accompanied by a sustained reduction in health care costs over 1 year of follow-up.

Chronic refractory angina pectoris: recent progress and remaining challenges

“…Enhanced external counterpulsation (EECP) was introduced in the 1990s and validated thereafter. 3 Coronary perfusion is enhanced during diastole by elevating the diastolic blood pressure based on the external compression of the lower extremites using inflatable cuffs. In addition, this procedure may stimulate therapeutic angiogenesis in the partially ischaemic heart.…”

New Advances in the Management of Refractory Angina Pectoris

“…44 However, EECP has been shown to reduce hospital costs. 45 Growing interest, robust randomised clinical trials and evidence of cost-effectiveness will serve to encourage EECP adoption going forward.…”

The Hemodynamic Effect of Enhanced External Counterpulsation Treatment on Atherosclerotic Plaque in the Carotid Artery: A Framework of Patient-Specific Computational Fluid Dynamics Analysis

“…As a kind of noninvasive and atraumatic assisted circulation procedure, enhanced external counterpulsation (EECP) has exhibited itself to be an effective, safe, and economical therapy in clinics for the management of ischemic cardiovascular and cerebrovascular diseases in the recent decades [1][2][3][4][5] and has been thought providing a better choice for patients with chronic stable angina who failed to respond to standard revascularization procedures and aggressive pharmacotherapy [6]. e treatment of EECP (see Figure 1) involves the use of an EECP device to inflate and deflate a series of compressive cuffs wrapped around the patient's calves, lower thighs, and upper thighs.…”