IVC filter usage is on the decline after years of complaints from patients who have suffered from filters moving or breaking apart in their bodies. Researchers note that between 2009 and 2015, IVC filter utilization fell in the United States among private insurance patients and Medicare patients. Usage fell 26.6% and 36.3% among these groups respectively.
Medicare patients have IVC filter utilization rates that are much higher than private insurers at a rate of 149 per 100,000 beneficiaries. Private insurance has 30 per 100,000 beneficiaries as their rate.
Nationally, utilization for Medicare patients is 500% higher than private insurance utilization.
In five of seven states, IVC filter utilization rose for both Medicare and private insurance holders despite a national decline in usage. Usage varies from state-to-state, with New Jersey Medicare beneficiaries having the procedure at a rate of 251.3 per 100,000 beneficiaries and Alaska having a rate of 48.4 per 100,000 beneficiaries.
Private insurers experienced the highest rate of utilization in Michigan, which has 59.5 procedures per 100,000 beneficiaries. Oregon had the lowest utilization rate among private insurers at 10.8 procedures per 100,000 beneficiaries.
IVC filter usage is on the decline due to high risks associated with the procedure and overuse in the past. Filters are now only recommended in the most extreme cases due to the high risks they pose to patients. Some of the devices have not been able to be removed, causing significant danger to patients.
The devices have been promoted as being “retrievable” in the past, but when doctors attempt to remove them, it becomes a challenging or impossible task.
Device migration, filter fracture, filter perforation and detachment of the device’s components are all risks that patients face. Device retrieval fails in about 2% of patients, leaving the patient with no means of safe retrieval in many circumstances. Between 2005 and 2010, the FDA received over 900 reports of adverse events relating to IVC filters.