The Pipeline

Robotic PCI: Is it worth the cost?

Haley David

Due to increasing cost pressure and decelerating reimbursement, hospital administrators are especially wary of high-cost, niche capital investments. Our researchers examine these technologies carefully—considering patient satisfaction, physician preferences, and downstream repercussions.

The Corindus Vascular Robotics’ CorPath 200, presented at this year’s Cardiovascular Research Technologies (CRT) conference, was one such technology that offered tremendous physician satisfaction but left us wondering, is it really worth the cost?

Robotic PCIs decrease radiation exposure, minimize learning curves

The Corindus Vascular Robotics’ CorPath 200, approved by the FDA in July 2012, lets physicians perform robotic-assisted percutaneous coronary interventions (PCIs). Remote controls allow the physician to guide balloon or stent catheters while sitting in a lead-lined operator console.

Clinical trials have demonstrated a 95% reduction in radiation exposure with this technology, along with strong safety and efficacy. Researchers also boast a 24-minute average procedure time and a learning curve of three procedures.

High-cost technology warrants due diligence before investing

With interventionalists increasingly suffer from occupational injuries such as spine injuries and brain tumors, the CorPath 200 does serve a purpose. However, hospital executives will have to ask whether it's worth the cost of investment. While price specifics are unavailable for this technology, similar platforms, such as remote catheter navigation, can cost upwards of $1.6 million.

Adoption of said platforms is tempered at best, requiring a committed physician champion to achieve return on investment. In a declining PCI business, justifying a robotic platform for these cases will be challenging, especially since these procedures are relatively straightforward, averaging one hour case times with conventional techniques. Comprehensive outcomes-driven data and cost-effectiveness research are needed to evaluate how much benefit robotic PCI may add.

Decreased revascularization an attractive outcome in payment reform

There was one compelling argument made for CorPath adoption: the system’s potential to decrease revascularization. Reportedly, 10 to 20% of PCI patients require a second stent due to inaccurate stent size and placement.

CorPath researchers claim the platform helps increase visualization and improve measurement. The ability to decrease this unnecessary utilization is an attractive outcome in today’s changing market. However, direct clinical data demonstrating these improvements has yet to be published.

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