Yes to cardiac devices. But at what cost?

Abstract

This editorial refers to ‘Cost-of-illness study of patients subjected to cardiac rhythm management devices implantation: results from a single tertiary centre’ by J. Fanourgiakis et al ., on page 366 We are the fortunate witnesses of a relentless progress in clinical electrophysiology and device therapy. This has mainly been attributable to refinements in ablation techniques for atrial fibrillation and other arrhythmias as well as the development of cardiac resynchronization therapy and implantable cardioverter-defibrillator (ICD) therapy. The proven clinical benefits of these therapies have led to their inclusion in clinical guidelines and their application to an increasingly wide patient group. The benefit of cardiac rhythm management device (CDRM) therapy comes at a cost, which includes a high device cost, an expensive implantation procedure, and a hospitalization. At a time when money is short and healthcare costs are being scrutinized by government, it is appropriate to ask whether CDRMs are affordable. Increasingly, this question is being directed not only at commissioners but also, to secondary care and primary care doctors. To answer this question, we must rely on economic evaluations. Cost of illness …