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The Eucomed Monitorings in Europe
EHRA Summit, Heart House, Sophia Antipolis, March 16th, 2009
Oern R. Stuge, MD, MBAMember of the Eucomed Board of Directors
2
Eucomed: - Voice of Medical Technology
European Medical Technology Industry Trade Association
Field: Prevention, treatment and amelioration of disease and disabilityEucomed represents:
4500 companiesTotal Employment 435,000 people. (2007)Total revenue of member companies; 63.6 bn Euros
Board of Directors: Corporate and Association representatives
3
Eucomed Monitorings of CRM Devices
Started in 2003 – present
Annual collection from the different device manufacturers till end 2004
Quarterly since Q1-2005
Result:Implants per million inhabitants per country –European countries•ICD, CRT-P, CRT-D, IPGs
4
Low Power Devices - Implant per Million Inh
The 2008 Preliminary data cannot to be shared, and has been replaced with the 2007 dataFinal implant rates for 2008 will be available on Eucomed website
http://www.eucomed.be/press/downloads.aspx Under “Graphs and statistics” section.
Avg = 941Avg = 916
BelgiumGermany
ItalyFranceAustria
Western EuropeSweden
USAFinland
PortugalSpain
SwitzerlandDenmark
NetherlandsUK
NorwayIreland
0 200 400 600 800 1000 1200 1400
IPG CRT-P 2007 WE Average 2006 WE Average
5
High Power Devices - Implants per Million Inh
The 2008 Preliminary data cannot to be shared, and has been replaced with the 2007 dataFinal implant rates for 2008 will be available on Eucomed website
http://www.eucomed.be/press/downloads.aspx Under “Graphs and statistics” section.
Avg = 189
Avg = 160
USAGermany
ItalyNetherlands
DenmarkAustria
Western EuropeIreland
BelgiumSwitzerland
FranceFinland
SwedenUK
NorwayPortugal
Spain
0 100 200 300 400 500 600 700
ICD CRT-D 2007 WE Average 2006 WE Average
6
CRT Devices - Implants per Million Inh
Preliminary data, not to be distributed,Final implant rates will be available on Eucomed website
The 2008 Preliminary data cannot to be shared, and has been replaced with the 2007 dataFinal implant rates for 2008 will be available on Eucomed website
http://www.eucomed.be/press/downloads.aspx Under “Graphs and statistics” section.
Avg = 88Avg = 76
USAItaly
NetherlandsGermanyBelgium
DenmarkAustria
SwedenWestern Europe
FranceUK
SwitzerlandNorwayIrelandSpain
PortugalFinland
0 50 100 150 200 250 300
CRT-D CRT-P 2007 WE Average 2006 WE Average
7
0
10
20
30
40
50
60
Portugal Ita
lySpain
FranceGerm
any UKFinlandBelgiumDenmark
Netherlands
AustriaSweden
Switzerl
andIre
land
Norway
00.511.522.533.544.55
Based on 2007 CIA world factbook & Eucomed data 2007
GD
P pe
r per
son
$ 10
00 (P
PP)
Implants/G
DP (1000 $)
GDP
CRT+CRT-D Implant rates/GDP
Weak link between wealth and CRT implant rates
8
SCD is a leading cause of death in Western Europe – more than stroke, AIDs, lung or breast cancer ~400.000 deaths/year1
Patients at risk are identified by the guidelines2
>85% of European indicated patients according to the ESC HF 2008 guidelines did not get a device3
ICD Implants
< 15% have access3
ICD Therapy in Western Europe:
Western Europe
1. Priori S.G. et al. Task Force on Sudden Cardiac Death, European Society of Cardiology – Summary of recommendations. Europace. 2002; 4: 3-182. HF2008 ESC Guidelines 3. Medtronic Data on File Jan 2008
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Western Europe
CRT Implants
< 25% have access4
Heart Failure is a major cause of death and hospitalizations in Europe1
Patients who benefit from CRT devices are identified by the guidelines2
The risk of being hospitalised for worsening HF is reduced by 52% by CRT3
>75% of European indicated patients according to the ESC HF 2008 guidelines did not get a device4
CRT Therapy in Western Europe
1. Priori S.G. et al. Task Force on Sudden Cardiac Death, EuropeanSociety of Cardiology – Summary of recommendations. Europace. 2002; 4: 3-182. HF 2008 ESC Guidelines3. Cleland. NEJM 2005;352: 1539-15494. Medtronic Data on File Jan 2008
10
CRM Devices in Calendar Year 2008
Huge disparity between countries and also within countries
Patients treated during this year:
IPG: 127,586;
ICD (excl CRT-D): 18,119; CRT: 14,815
Growing at 8%
But untreated patients remain > 80%
Less than 15% ICD eligible patients received an ICD
Less than 25% CRT eligible patients received a CRT device.
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Out of Hospital Sudden Cardiac Arrest
Even out of hospital SCA patients may go untreated1
For Western Europe, this would mean:7,000 patients2 are•Admitted for SCA•Discharged without an ICD when they may
need it
1Sterk B et al, Europace. 2004 May;6(3):179-832 Calculated based on Sterk B et al, 5% National average survival – US, and Priori S.G. et al. Task Force on Sudden Cardiac Death, European Society of Cardiology –Summary of recommendations. Europace. 2002; 4: 3-18
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EHRA
Will EHRA play a role in reducing the number of untreated indicated patients in Europe?How can Eucomed help?
Thank you