Fractional flow reserve : impact du remboursement sur son utilisation en cardiologie interventionnelle - juin 2020

Par Samuel Cohen - Mise en ligne le 18 octobre 2020

Mots clefs : cardiology practices, reimbursement, medical device

J Pharm Clin 2020 ; 39 (2) : 77-84

Fractional flow reserve: impact of reimbursement in interventional cardiology practices

Samuel Cohen, Veronique Lecante, Jean-Luc Durand, Quentin Fischer, Aures Chaib, Albert Boccara

CHI Andre Gregoire, Montreuil, Services de Pharmacie Clinique & de Cardiologie, France

Abstract. Background. Fractional flow reserve (FFR) is a cardiovascular exploration method used in our hospital since June 2009. It allows to evaluate in the catheterization lab, the hemodynamic character of a coronary lesion using a pressure guide. FFR is registered in the joint classification of medical procedures and reimbursed since November 2015. The purpose of the study is to define how the reimbursement of FFR will modify therapeutic management of patients in interventional cardiology. Methods. A retrospective and observational study was performed over a period of 5 years. These patients (216) were separated into 2 groups: group A and group B patients with a FFR before and after the reimbursement respectively. The clinical impact of the reimbursement is judged on the angioplasty/ coronarography ratio to determine the number of angioplasties avoided. Results. The positivity rates of FFR do not differ significantly between the two groups. During the second period, a significant decrease in the number of angioplasties (angioplasty/coronarography ratio group A = 0.43 and angioplasty/coronarography ratio group B = 0.39; p = 0.04) is established. Conclusion. Eventually, if the listing of the act remains reimbursed at 148 euros and the medical device reimbursed, the FFR would allow a significant saving for the hospital allowing to reduce the number of angioplasties and implanted stents.