The only available drug for the treatment of the most common type of stroke is the clot buster known as tPA. This treatment was first approved by FDA 20 years ago. The cost of tPA jumped by 111% between 2005 and 2014, but reimbursement rose by only 8%, reported Dawn Kleindorfer, MD, University of Cincinnati, Ohio at the International Stroke Conference held last month in Los Angeles. “The reason the cost has gone up so much is unclear [and] the reason that reimbursement has not kept pace with the cost is complicated,” she said. “It has to do with the way it’s calculated and the fact that Medicare/Medicaid is cutting hospital reimbursements across the board.” She called on stroke physicians to lobby for increased payments to hospitals for tPA-treated patients. Ralph Sacco, MD, Brain Institute at the Miller School of Medicine, University of Miami, Florida, said, “There’s a disconnect here. A drug that is really amazingly productive for acute stroke has risen greatly over time in price, while the reimbursement for acute stroke has not risen at the same rate.” He said he agrees that it is “important for all of us to lobby Medicare and the other reimbursers…to make sure that stroke is adequately covered.”
Courtesy American Heart / American Stroke Association