Several topics were of particular interest at the 2012 Society of Interventional Radiology (SIR) conference , ranging from advanced clinical techniques in peripheral revascularization and embolization to the regulatory and economic climate for IR practice in the US.
Cook Group President, Kem Hawkins, highlighted some of the concerns and trends in a changing medtech landscape such as rapidly increasing costs, while the number of device approvals in the form of pre-market approvals (PMAs) was on the decline from 2004 to 2009. Additionally, long product approvals and delays in achieving reimbursement status often mean that devices are available in other markets before the US. He did not spare the industry either, mentioning that nearly $25 billion in settlements paid by the pharmaceutical and medtech industries from 2001-11 has led to a degree of mistrust between the public and various stakeholders. Mr. Hawkins felt that returning to patient-centric focus would help align the goals between clinicians, industry and patients.
Another hot topic was healthcare reform, and more specifically, the focus on evidence-based medicine. Several speakers noted that the difficulties of producing level 1 evidence in the form of large, randomized controlled trials due to issues of funding, patient recruitment and selection, as well as properly defining clinically relevant endpoints. In fact, the majority use of some currently available devices are off-label, based on the results of small, single center studies.
In the IR landscape itself, Dr. John Kaufman presented his perspectives on how IRs fit into the overall healthcare delivery paradigm, as well as the challenges that IRs have and will continue to encounter. These include branding issues such as the misconceptions as to what an IR actually does and the difference between a diagnostic radiologist (DR) and an IR. Furthermore, he highlighted the changing competitive landscape where IRs and vascular surgeons have traditionally competed, with increasingly encroaching interventional cardiology practices further adding a competitive element. Additionally, due to the high costs of large capital equipment, IRs continue to compete with DRs over imaging modalities such as MRI and CT scanning equipment. Dr. Kaufman felt that the path forward was greater investment in research to develop a strong body of clinical evidence, especially for diseases that don't have suitable treatments currents, better partnership with industry, and continued improvement in training for new devices and techniques.