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Medicare previously reimbursed these expenses only for patient self-testers who had mechanical heart valves. The new coverage expands to includethose on anticoagulant medication with chronic atrial fibrillation and venousthromboembolism.
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"The decision to expand coverage to additional disease states allowsphysicians to manage more of their patients on warfarin therapy through hometesting," said Dr. Alan Jacobson, cardiologist, Loma Linda University Schoolof Medicine. "Studies show that more frequent PT/INR testing leads toimproved clinical outcomes. The benefits of providing patients with improvedaccess to testing are reductions in strokes, bleeds and deaths."
According to a 2006 international meta-analysis led by Dr. Carl Heneghanand published in the Lancet, patient self-monitoring of oral anticoagulationleads to a significant one-third reduction in death from all causes. The studyalso showed that thromboembolism was decreased by 55 percent and majorhemorrhage was also decreased.(1)
Studies suggest that anticoagulation patients who self-test may experiencefewer complications overall than those who do not because self-testing mayincrease patient time in therapeutic range. A 2001 study published in ZKardiol reported that over a two-year period, 80 percent of PT/INR valuesrecorded by mechanical heart valve patients who performed self-testing were intarget therapeutic range, compared to only 64.9 percent of PT/INR valuesmonitored by family practitioners.(2)
Studies also suggest that PT/INR self-testing is just as accurate astesting performed by a healthcare professional.
In a 2001 study published by the American Journal of Clinical Pathology,there were no significant differences between PT/INR results gathered from thelaboratory and self-testing patients.(3) Performance testing with theCoaguChek XS System also showed a 97-percent correlation between resultsobtained by healthcare professionals and by patients testing themselves.(4)
"I feel comfortable with more of my patients monitoring from home becausehandheld meters like the CoaguChek XS System are easy to use, cause less painand improve compliance," said Dr. Jacobson. "I also know the results will beconsistent with the results from our office meter and from the lab."
Patients prefer fingerstick testing over painful venous draws, accordingto a 2002 study measuring the results of the Prothombin Office-Testing BenefitEvaluation (PROBE) published in Cardiovascular Reviews and Reports.(5)Several studies also show that the accuracy of results from fingersticktesting is comparable to that of outside laboratories.(6, 7)
For more information on the CoaguChek XS System for Patient Self-Testing,visit www.poc.roche.com .
About Anticoagulation Monitoring
Certain patients with atrial fibrillation, a mechanical heart valve ordeep vein thrombosis require protection against thrombosis, or blood clots.They are typically put on lifelong oral anticoagulation therapy with warfarinsodium (e.g., Coumadin) to thin their blood. Each patient reacts differentlyto anticoagulant medications, so it is imperative to monitor therapeuticeffects closely to minimize potential risks.
About CoaguChek products
Physicians have been using CoaguChek instruments for point-of-care PT/INRtesting since 1994. Today, in the U.S., more point-of-care PT/INR tests areperformed with a CoaguChek system than with all other devices combined.(8) TheCoaguChek XS System represents the fifth generation o
