It’s a planing stroke that goes wrong. Since 1is March, thrombo-aspiration catheters are no longer covered by Social Security. These state-of-the-art medical devices, used by neuroradiologists to perform mechanical thrombectomies, are nevertheless essential for the emergency treatment of certain patients who are victims of cerebrovascular accidents (CVA). Deprived of reimbursement from the State, they will now be entirely the responsibility of hospitals.
This decision makes the caregivers jump. Because this extremely precise medical device, which needs to be renewed at each intervention, is expensive. On average, its cost is 1,500 euros per kit. While many establishments are facing a perilous financial situation, this new expense worries health professionals. “Once again, the public hospital and its actors will have to bear the financial weight of innovative techniques that bring significant improvements in the service provided to our compatriots”were moved by the French Society of Neuroradiology (SFNR) and the French Neurovascular Society (SFNV) in a letter addressed to the Minister of Health.
“Two weeks earlier, he said it was time to turn our backs on accounting logic! », annoys Julien Gottsmann, general manager of the Rothschild Foundation hospital in Paris. The healthcare facility performs more than 300 mechanical thrombectomies each year. “For us, this will represent a net loss of 450,000 euros per year, even though it has been demonstrated that this technique saves lives and avoids serious sequelae for patients. This decision is incomprehensible and stupid”he points out.
Leading cause of death among women
A public health issue, stroke is now the third leading cause of death in men in France, and the first in women. It is also the first cause of acquired disability, the sequelae being particularly severe (paralysis, loss of speech, cognitive disorders, etc.). Since 2015, mechanical thrombectomy has been used to treat certain cases when the stroke is due to a cerebral artery blocked by a large clot. A thrombo-aspiration catheter, introduced in the groin and going up to the brain, is then used to dislodge the clot.
These devices were previously listed on « the list in their », a derogatory financing mechanism which makes it possible to cover the cost of devices or treatments deemed to be innovative. This coverage, added to the reimbursement for the hospital service – a flat rate applied to each pathology which takes into account the nights of hospitalization, the care provided, the mobilization of the nursing staff, etc. –, allowed the hospitals to be reimbursed by the Social security up to a total of 11,500 euros for a patient treated for a stroke. Delisting thrombo-aspiration catheters from the list thus lowers this envelope by 13%.
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