Trends in utilization of microaxial flow pump and intra-aortic balloon pump across 3 countries

Rising health care spending is threatening the sustainability of health systems in many high-income countries. While health technology assessment (HTA) is used in the UK and Canada to guide payment decisions for new technologies, the US has historically lacked a formal national HTA process. However, the Centers for Medicare & Medicaid Services have begun working toward incorporating HTA in certain circumstances through national coverage determination policies. Microaxial flow pumps (MAFPs) (eg, Impella) and intra-aortic balloon pumps (IABPs) are costly cardiac devices frequently used to provide hemodynamic support in complex percutaneous coronary interventions (PCIs) and patients with myocardial infarction with cardiogenic shock. Despite widespread use in the US and other countries, effectiveness data remain limited. We aimed to evaluate the adoption and deadoption of MAFP and IABP in patients undergoing PCI in the US, UK, and Canada to understand how utilization patterns vary across countries.