From January 1, 2007, new Medicare beneficiaries at risk from abdominal aortic aneurysms (AAAs) have the opportunity to be screened using ultrasound technology. This screening is now part of the Welcome to Medicare physical for many seniors who have certain risk factors. The screening programme is a result of the Screen Abdominal Aortic Aneurysms Very Efficiently (SAAAVE) Act, passed by the US Congress in November 2005. The introduction of the Act comes the UK government is expected to endorse a similar screening program, supported by the Vascular Society of Great Britain and Ireland.
The Act was conceived by the Society for Vascular Surgery (SVS) in early 2004 and was aided by the US Preventative Services Task Force. At risk are men who have smoked sometime during their lives, and men and women with a family history of AAA. “AAA screening is an important measure that will save thousands of American lives each year,” said vascular surgeon Dr Robert Zwolak, a professor at Dartmouth Medical School. “Our SVS members worked diligently on SAAAVE. These vascular surgeons concentrate their practices on the prevention and cure of vascular disease, and they know the effectiveness of screening in saving lives.”
The SAAAVE Act was sponsored in Congress by Senator Christopher Dodd, Senator Jim Bunning, Senator John Shimkus, Senator Ron Lewis, and Senator Gene Green. The Act also was endorsed by the National Aneurysm Alliance, a group of medical professional organizations, patient advocates, individuals and medical technology manufacturers dedicated to reducing the number of Americans who die from AAAs.
However, due to budget constraints, only new entrants to Medicare part B will be screened, therefore seniors who have already had their ‘Welcome to Medicare’ physical exam will not be retrospectively screened. By restricting the screening to only new Medicare entrants, the congressional budget estimate is only US$200 million over five years. “This includes the cost of scan – at $50-70 a time – and aneurysm treatment,” he explained. There are many variables to the cost. There are 600,000 new Medicare beneficiaries every year; slightly less than half are male, but most have smoked at some point in their life, which leaves slightly less than 300,000 eligible candidates,” explained Zwolak.
“Some 15,000 people die each year from ruptured AAAs and 60% of patients die before reaching the hospital. A further 20% die in the hospital after emergency surgery – we believe the major cost savings are for those who make it to the hospital as they use a huge amount of resources in terms of emergency surgery and recovery in intensive care,” He added.
As a result, Zwolak said that the SVS wants to increase the uptake of screening benefits such as this, which is currently only at around 10-15% of those eligible. “The next steps are for us to work with the Medicare authorities to provide a smooth implementation of the program, and to disseminate information on the danger of AAAs,” he concluded.