The impact of implantable cardioverter defibrillator therapy on health care systems.

Abstract:

:Implantable cardioverter defibrillators (ICDs) are now widely used for the secondary prevention of sudden cardiac death and are being offered as a primary preventive therapy. This technology has potential for significant fiscal impact on health care budgets. Technologic innovation will result in more complex devices that are more effective and better accepted by patients and physicians. The clinical impact of these devices will be predicated, in part, by absolute survival benefits but also by their relative advantages over alternative therapies in terms of survival, safety, morbidity, quality of life, and cost. The impact on public health will depend on the effectiveness of screening methods for identification of populations likely to benefit from primary prevention. Risk stratification algorithms are now being tested in several ongoing clinical trials. Dilution of benefit by competing illnesses may occur to different extents in individual patient populations. The economic impact is predicated on the future cost of ICD systems, limitation of hospitalization costs associated with this therapy, and accurate prospective stratification in primary prevention populations. Cost efficacy analyses and quality of life assessment in ongoing and future clinical trials are essential to the development of this therapy and its diffusion into different health care systems. Achievement of clinical benefits, functional independence, and a return to gainful employment by patients will be important determinants of the support lent by health care systems to the dissemination of this therapy.

journal_name

Am Heart J

journal_title

American heart journal

authors

Saksena S

doi

10.1016/0002-8703(94)90109-0

subject

Has Abstract

pub_date

1994-04-01 00:00:00

pages

1193-200

issue

4 Pt 2

eissn

0002-8703

issn

1097-6744

pii

0002-8703(94)90109-0

journal_volume

127

pub_type

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