Radiologists’ share of catheter-directed therapy market falls as surgeons, cardiologists gain inroads
Radiologists’ share of the catheter-directed therapy market has fallen over the course of a decade as cardiologists and surgeons gain inroads, according to new research published Monday, Aug. 16.
Popularity of this procedure—using imaging guidance to insert a tube for treatment of blood clots in lower extremities—has grown since 2007, with interventional rads the dominant player. That year, the specialty delivered 72% of such minimally invasive services for deep-vein thrombosis among Medicare beneficiaries, which fell to 57% by 2017, Ohio State experts found in a recent analysis.
Practices should take note of these evolving patient preferences, experts asserted in the Journal of Vascular and Interventional Radiology.
“Despite radiologists performing the majority of procedures each year, it is evident from the results of this study that radiologist market share for these venous interventions [is] declining,” corresponding author Mina Makary, MD, with Ohio State University Wexner Medical Center’s Department of Radiology, and colleagues concluded. “As the continued development of novel techniques allows for minimally invasive treatment of an increasing breadth of pathologies once only amenable to open procedures, it would benefit endovascular specialists to pay close attention to these practice patterns,” they added later.
For their study, Ohio State researchers tapped Centers for Medicare & Medicaid Services databases, seeking all claims associated with chronic, lower-extremity deep-vein thrombosis. They found the number of catheter-directed therapy claims climbed from 4.27 per 100,0000 Medicare beneficiaries up to 13.4 a decade later, a more than 12% increase. Radiologists performed the lion’s share of such procedures every year during the study period, except for 2013. That year rads delivered almost 47% of catheter insertions compared to 53% for surgeons and cardiologists combined.
Meanwhile, catheter-directed therapy also shifted to outpatient providers, jumping from 7% in 2007 up to 29% by the end of the study period, with inpatient still the dominant setting.
“As similar studies have demonstrated similar inpatient-to-outpatient shifts for other procedures, these findings may compel traditionally inpatient subspecialties to further bolster outpatient and clinical infrastructure,” Makary and colleagues wrote.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.