Utilization of coronary angioplasty and cost of angioplasty disposables in 14 western European countries

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Abstract
An inventory has been made of the practice of angioplasty in 14 European countries from 1985 onwards. The numbers of procedures performed varied in 1985 from 3 to 186 per million inhabitants, in 1991 from 52 to 716. All countries showed a steady increase, but the highest performer, Belgium, achieved only 55% of the number of angioplasties performed in 1991 in the U.S.A. No relation was found between the number of angioplasties and death rate for ischaemic heart disease, national income, number of cardiologists or spending on health care. The number of catheterization laboratories was related to the number of procedures. Prices of angioplasty disposables varied widely between countries. In 1989 Italy and Spain had very high costs, averaging almost 2500 ECU and 2000 ECU for ACS and Schneider balloon catheters respectively, while Switzerland and the U.K. were cheap with costs between 700 ECU and 500 ECU for the same products. In 1991 average prices for balloon catheters fell by 25% in Spain, while in Switzerland average prices increased by 10%, bringing the almost four-fold price difference in 1989, down to a difference of 2.5 in 1991. If the U.S.A. is taken as a standard and set against the death rate from ischaemic heart disease in Western Europe in 1991 the number of ‘missing’ angioplasties was 215 500, the U.K. accounting for 42% of this deficit.

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