MyoCell therapy "$35,000 to $45,000 range" per patient
The cost of MyoCell therapy is projected to be in the $35,000 to $45,000 range and includes the harvesting of the muscle cells, the laboratory processing of the cells, and the consumable delivery technology (MyoCath). Additional therapy costs will include one hour of cath lab time and a two to six day inpatient stay for post- therapy monitoring. Not including professional fees, these costs add $2,200 to $3,500 to the procedure. Additionally, initial costs would include diagnostic testing, such as stress tests, ultrasounds, and EP studies, to determine the extent of the cardiac tissue damage and to determine if the patient is a candidate for MyoCell therapy.
Reimbursement for a unique technology is difficult to determine. Currently, there are no existing CPT, DRG, or APC codes that reflect autologous cell therapy for the treatment of damaged myocardium because it is still an investigational therapy. When approved, BioHeart can apply for a new technology add-on payment. If the application is accepted, Medicare would pay a marginal cost factor of 50% of the costs for the new technology in excess of the full DRG payment. Considering ICDs (implantable cardioverter defibrillator) cost $23,000 or more and have to be replaced every four to seven years, Myocell therapy will be a primary candidate for additional reimbursement. External Cardiac Basal Annuloplasty
Vendors: • Mardil, Inc. – BACE (Basal Annuloplasty of the Cardia Externally) • Myocor, Inc. (Edwards Lifesciences) – Coapsys and iCoapsys devices • Acorn Cardiovascular – CorCap Cardiac Support Device • Paracor Medical Inc. – HeartNet
Each year, approximately 100,000 surgical procedures are performed to replace or repair a defective heart valve. Unfortunately, heart valves only last 10 to 15 years and there’s a surgical mortality rate of 2% to 5%. In addition, patients are required to take anticoagulants for the rest of their lives. As a result of these dilemmas regarding cardiac surgical procedures, external cardiac basal annuloplasty devices were developed to support and reshape the heart muscle into its normal state to allow the heart valves to open and close properly. The system uses mechanical/mesh systems applied to the base of the heart to prevent leakage and regurgitation of heart valves in a simpler and safer procedure without the need for replacement or cardiac bypass support during surgery. This method should render improved outcomes and allow for a wider range of surgery candidates.
Competing Technologies: • Heart Value Replacement and Repair Surgery Costs: • Device – $10,000 to $20,000 • Implantation – $15,000 to $20,000
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