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European Heart Journal Advance Access published online on October 10, 2006
European Heart Journal, doi:10.1093/eurheartj/ehl311
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European Heart Journal © The European Society of Cardiology 2006; all rights reserved
Received September 13, 2006
Accepted September 21, 2006

Current opinion

The high cost of implantable defibrillators

Mark A. Hlatky 1 * and Daniel B. Mark 2

1 Stanford University School of Medicine, HRP Redwood Building, Room 150, Stanford, CA 94305-5405, USA
2 Duke University Medical Center, Durham, NC, USA

* To whom correspondence should be addressed.
Mark A. Hlatky, E-mail: hlatky{at}stanford.edu


  Abstract

Increased use of ICDs in patients with cardiac disease has the potential to strain national health care budgets because of the large numbers of eligible patients and the high cost of the ICDs. Randomized trials show ICDs increase life-expectancy in some groups of patients and also increase total medical costs significantly. ICDs exemplify the role of new technology as the main force behind rising health care costs. ICDs have not been used in all eligible patients, in part because of cost, but also because of patient resistance and a shortage of specialists able to implant and manage complex ICDs. The cost-effectiveness of ICDs would be improved by development of simpler and cheaper devices, and by better tools to identify patients who benefit from an ICD.

Keywords: Cost-effectiveness; Implantable defibrillator; Sudden death.
The opinions expressed in this article are not necessarily those of the Editors of the European Heart Journal or of the European Society of Cardiology.
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