Healthcare leaders look at the path of cardiovascular medicine

story6_revScientific Sessions 2016 was a big event for the medical community, and it attracted a variety of renowned speakers. Two of those big speakers — Robert Califf, MD, Food and Drug Administration commissioner, and Victor Dzau, MD, president of the Institute of Medicine — looked at the role of cardiovascular medicine in the near future.

Califf used his position as head of the agency that regulates the use of new medicines and devices to discuss the changing focus of cardiovascular care. In his Nov. 13 address, “Groundbreaking Studies in the Practice of Cardiovascular Medicine: Circulation Editors’ Choices,” he compared the number of drugs being developed in various medical specialties.

Several new compounds are being developed for use in oncology and anti-infectives, while cardiovascular medicine is among the specialties where drug development is flat, he said. Other specialties in the second group include musculoskeletal, endocrine, immune system, respiratory, gastrointestinal and hematology.

“This is a wakeup call for all of you. If you look at the pipeline of compounds in preclinical (development for cardiovascular medicine), you will notice there are several (specialties) that are doing pretty well, but cardiovascular is in that group that is losing that race by a major amount,” Califf said. “We can argue whether that is good or bad because there are so many effective drugs in cardiovascular medicine, but you should be aware of these data.

“Cardiovascular medicine is not a place where industry is investing right now in new molecules. There are specific issues in cardiovascular medicine that deserve our mutual attention now.”

Dzau touched on issues outside of drug development that should be part of the cardiovascular medicine agenda in coming years.

“Health care determines 10 to 20 percent of health. The rest is social behavior issues,” he said. “What does that mean for the cardiovascular disease agenda? First of all, (the focus should be on) chronic disease prevention. Promote cardiovascular health.

“My feeling is we have to put forward an agenda that is about increasing physical activity, creating food and beverage environments that ensure health and strengthening federal efforts and state efforts to reduce use of tobacco products by youth. (We need to be) building health infrastructure and health systems so they have the capacity to implement those programs that promote health and prevention.”

Also affecting the future of health care is the changing political climate that is expected to lead to the repeal of the Affordable Care Act. It is important that cardiovascular medicine focus on measures that have bipartisan support and are likely to remain intact, such as Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), he said.

“The future does look good despite the uncertainty we face,” Dzau said. “I believe that if all of us believe in these areas, we can do (better in health care) irrespective of what administration is in place (by focusing on) better health and well-being, high-value health care and strong science and technology.”