SMARTER PATIENTS-CHEAPER CARE?

摘要

Whenever researchers compare drugs or treatments to see which works best, somebody's ox gets gored. Such "comparative effectiveness" studies have already cast doubt on expensive newer blood pressure and schizophre -nia drugs, as well as spinal fusions and other surgeries. And in one case, it is a very expensive ox: the heart procedure known as angioplasty.rnEach year, more than 1.3 million Americans have their clogged arteries widened with a tiny balloon and then propped open with slender mesh tubes called stents made by companies like Johnson & Johnson and Boston Scientific. The total bill for these angioplasties is more than $21 billion a year. But while many patients and doctors firmly believe that angioplasties prevent heart attacks, the data say otherwise. A series of studies-the newest published in the June 11 issue of The New England Journal of Medicine-finds that stable patients with chronic heart disease who have the procedure get little benefit compared with patients treated just with drugs.