Study of Managed Care Population Suggests Inferior Vena Cava Filters May Be Overused
07 July 2017 - 3:35AM
Business Wire
Humana Inc. (NYSE: HUM) today announced research findings that
suggest inferior vena cava (IVC) filters may be overused in managed
care populations, and that filters may not always be removed after
they are no longer needed.
The study, published in the Journal of Thrombosis and
Thrombolysis, compared health outcomes between patients who
received IVC filters and patients who were potentially eligible for
filters but did not receive them.
IVC filters were developed for patients who are at risk of deep
vein thrombosis (DVT) (a thrombosis is a blood clot) but are unable
to receive anticoagulants for preventive treatment, either because
they aren’t effective for these patients or because of recent
surgery or other contraindications.
During the procedure, the filter is placed in the inferior vena
cava vein, the body’s largest vein, and serves to catch clots
migrating from other parts of the body before they can get to the
heart or lungs and potentially cause a life-threatening condition
called a pulmonary embolism (PE).
Though the filters are only recommended for patients who cannot
use anticoagulants, the study found that anticoagulant use was
actually greater in patients who had undergone filter placement
than in patients who had not received filters. This finding implies
that IVC filters are frequently used in cases that do not meet the
criteria of clinical practice guidelines.
This is a cause for concern, as the study also found that
patients who received filters experienced higher rates of
subsequent hospitalization and hospital readmission than those
without filters. Other publications in the medical literature
reveal that many experts believe that IVC filters are used too
often.
In general, IVC filters are designed to be removed when they are
no longer needed. Removal is important because the filters
themselves can eventually cause DVT. Complications such as filter
migration are also possible.
In agreement with previous research on removal rates, the study
found that filters were removed in only a small percentage of
patients. Removal occurred in six percent of patients who received
filters because of a history of DVT or PE, and 16 percent of those
who had filters to prevent DVT or PE following surgery.
“Given that IVC filters were associated with greater rather than
diminished use of anticoagulants, our research suggests that IVC
filters may be overused,” said Mitchel Seleznick, MD, MPH, lead
author of the study and medical director, CarePlus, a Humana
affiliate. “In addition, the low rates of filter removal indicate
that patients may be at unnecessary risk of filter-induced
DVT.”
“These real-world findings confirm what previous research has
reported for patients in academic medical centers,” said Laura
Happe, PharmD, MPH, director of research and publications at
Humana. “This study, which joins a growing body of research,
underscores the need for closer compliance with clinical practice
guidelines for IVC filters.”
In the United States, one or two of every 1,000 individuals
develops either DVT or PE each year, and approximately one third of
these cases will experience another DVT or PE within 10 years.
The study evaluated a managed care population with Humana health
care coverage from 2013 to 2014. This included 435 recipients of
prophylactic IVC filters, 4,376 recipients of therapeutic IVC
filters, and two control groups, each matched to filter
recipients.
In addition to Dr. Seleznick, co-authors of the study include
Jamieson Vaccaro, MA, research scientist, and Karen Worley, PhD,
pharmacy research manager, both of Comprehensive Health Insights,
which is a research arm of Humana.
About Humana
Humana Inc. is committed to helping our millions of medical and
specialty members achieve their best health. Our successful history
in care delivery and health plan administration is helping us
create a new kind of integrated care with the power to improve
health and well-being and lower costs. Our efforts are leading to a
better quality of life for people with Medicare, families,
individuals, military service personnel, and communities at
large.
To accomplish that, we support physicians and other health care
professionals as they work to deliver the right care in the right
place for their patients, our members. Our range of clinical
capabilities, resources and tools – such as in-home care,
behavioral health, pharmacy services, data analytics and wellness
solutions – combine to produce a simplified experience that makes
health care easier to navigate and more effective.
More information regarding Humana is available to investors via
the Investor Relations page of the company’s web site at
www.humana.com, including copies of:
- Annual reports to stockholders
- Securities and Exchange Commission
filings
- Most recent investor conference
presentations
- Quarterly earnings news releases and
conference calls
- Calendar of events
- Corporate Governance information
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version on businesswire.com: http://www.businesswire.com/news/home/20170706005919/en/
Humana Corporate CommunicationsAlex Kepnes,
502-580-2990akepnes@humana.com
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