IVC filter utilization down nationally, but still higher among Medicare patients

Researchers have tracked inferior vena cava (IVC) filter utilization in the United States from 2009 to 2015, noting that it decreased by 36.3% among Medicare patients and 26.6% among patients with private insurance. The team shared its findings in a new study published in the American Journal of Roentgenology.

"As device technology has matured, making IVC filter placement more widely accessible to patients because it is available from more providers in more locations, IVC filter placement utilization has increased steadily from the time of its inception nearly 50 years ago through the late 2000s,” wrote lead author Divya Kishore, a medical student at Emory University in Atlanta, and colleagues. “More recently, through the Choosing Wisely initiative and similar guidelines, physician professional societies have begun to assess indications for IVC filter placement more critically.”

Noting that most research on IVC filter utilization has exclusively focused on national Medicare data, the authors wanted to also look at how rates have changed for patients with private health insurance and how utilization differs from state to state.

Nationally, the authors found that IVC filter utilization from 2009 to 2015 was 149 per 100,000 beneficiaries for Medicare patients and 30 per 100,000 beneficiaries for patients with private insurance. State-level utilization rates in the Medicare population ranged from 48.4 (Alaska) to 251.3 (New Jersey) per 100,000 beneficiaries. Among privately insured patients, utilization ranged from 10.8 (Oregon) to 59.5 (Michigan) per 100,000 beneficiaries.

“Nationally, utilization in Medicare population was five times higher than that in the private insurance utilization,” Kishore said in a prepared statement from the Harvey L. Neiman Health Policy Institute. “Despite the national decline, utilization in Medicare and private insurance population increased in five and seven states, respectively.”

“Because attention is increasingly focused on the appropriate utilization of IVC filters, our observations emphasize the continued need for investigators to use more granular nonaggregate data sources that consider both geographic and payer population variables when using administrative claims data to study utilization, so as to begin to examine the potential drivers of change,” Richard Duszak, MD, professor and vice chair for health policy and practice in the department of radiology and imaging sciences at Emory University, said in the same statement. Duszak is also a senior affiliate research fellow at the Neiman Institute.