Utilization of coronary angioplasty and cost of angioplasty disposables in 14 western European countries

An inventory has been made of the practice of angioplasty in14 European countries from 1985 onwards. The numbers of proceduresperformed varied in 1985 from 3 to 186 per million inhabitants,in 1991 from 52 to 716. All countries showed a steady increase,but the highest performer, Belgium, achieved only 55% of thenumber of angioplasties performed in 1991 in the U.S.A. No relationwas found between the number of angioplasties and death ratefor ischaemic heart disease, national income, number of cardiologistsor spending on health care. The number of catheterization laboratorieswas related to the number of procedures. Prices of angioplasty disposables varied widely between countries.In 1989 Italy and Spain had very high costs, averaging almost2500 ECU and 2000 ECU for ACS and Schneider balloon cathetersrespectively, while Switzerland and the U.K. were cheap withcosts between 700 ECU and 500 ECU for the same products. In1991 average prices for balloon catheters fell by 25% in Spain,while in Switzerland average prices increased by 10%, bringingthe almost four-fold price difference in 1989, down to a differenceof 2.5 in 1991. If the U.S.A. is taken as a standard and set against the deathrate from ischaemic heart disease in Western Europe in 1991the number of ‘missing’ angioplasties was 215 500,the U.K. accounting for 42% of this deficit.