Study: Presence of sales reps influences coronary stent selection, price

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A sales rep’s visit could be worth as much as $230 per case in surgeons’ use of coronary stents, according to a study in the American Heart Journal. The presence of a company sales rep in the cath lab increased the likelihood that surgeons would opt for drug-eluting over bare-metal stents, researchers said.

The study, aimed at understanding the impact and influence of sales reps in PCI cases, examined the selection of stents in 1,145 patients over a 12-month period from 2008-2009.

"The presence of a sales representative not only increased the company’s market share, mainly in the more profitable DES market, but also shifted toward the use of a DES when the company’s products were used," investigator Dr. Doron Sudarsky wrote in a recent issue of the American Heart Journal.

The study included 1,785 implantations in total of stents from 5 different medical device manufacturers, including 1,086 DES, 680 bare-metal stents, and 19 anti-CD34 antibody-coated stents, TheHeart.org reported. The authors concluded that the presence of reps from companies that offered DES increased DES implantation in patients.

Researchers noted that the shift to drug-eluting stents did not have a negative impact on patient care, but cautioned that rep influence may push surgeons to choose newer, more expensive models of drug eluting stents, which increased costs by about $230 per case on average. In hospital systems where rep visits were more limited, the ratio of DES to bare-metal stents was reduce, according to the study.

The researchers suggested that more criteria is needed to govern the interaction of industry and physicians.

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