Ty Gluckman, MD: The Staggering Cost of Cardiovascular Disease Prevention

The role of prevention is paramount in treating cardiovascular disease (CVD), but the economic impact of the treatment is staggering.

Data suggest an excess of $200 billion in direct costs is spent on an annual basis on CVD in the United States alone, not inclusive of indirect costs or the toll of the disease.

In an interview with HCPLive, Ty Gluckman, MD, Providence St. Joseph Health, called to mind a concept that Benjamin Franklin coined in 1736, noting "an ounce of prevention is worth a pound of cure."

He presented a talk on the subject of CVD prevention at the 2022 American Society for Preventive Cardiology meeting in Louisville, Kentucky.

"The talk focuses on the concept and how we begin to move towards greater investment in preventive efforts up front to reduce the downstream impact, really looking from a population health perspective overall," Gluckman said.

He noted that the way care is reimbursed, particuarly through a fee-for-service model, is based upon patients undergoing events and treating events post-occurrence. The talk additionally discusses on focusing efforts where the money is being spent, regarding economic costs in individuals who have higher baseline risk.

"Those individuals have a greater spend on an annualized basis in terms of cardiovascular disease than those individuals that are low risk," he added.

Gluckman discussed challenges in the cost-effectiveness of common interventions, including reducing weight for those with increased body mass index (BMI), lowering blood pressure, and addressing appropriate interventions for those with coronary disease, diabetes, and ongoing tobacco use.

"Historically, while many of our therapies have been generic, in terms of pharmacotherapies, an increased number of our newer pharmacotherapies are now branded agents not generic and therefore associated with higher costs," Gluckman said.

The presentation additionally focused on national guidelines and their methodology to incorporate cost effectiveness and the incorporation of value into guidelines.

"Moving away from a one-size-fits-all approach that begins to individualize our treatment approaches to better match what may be more costly interventions in those individuals who are most likely to benefit from them," Gluckman said.

Moreover, he discussed the concept of value-based insurance design and communicating with the payer community to make investments and subsidize costly therapies in patients who are more likely to benefit from them.

In the interview, Gluckman additionally discussed the timeline of preventive efforts, the cost of medication, and what the long-term future looks like for this discussion overall.

For more from Dr. Gluckman, watch the above video.