NCPA - National Center for Policy Analysis

Medicare Debates Expanding Distribution of Heart Defibrillators

February 12, 2003

It's the central dilemma of modern medicine: Which patients should get high-cost but potentially lifesaving treatments, and which ones shouldn't?

A federal advisory committee plans to tackle that issue today when it considers whether to greatly expand the number of people in the Medicare program who are eligible for an implanted heart defibrillator.

  • Medicare already pays for the devices for the 27,000 patients a year considered at highest risk of sudden death.
  • But in March 2002, a pivotal study found that the defibrillators could reduce the risk of death for many more heart-attack survivors.
  • Medicare pays $25,000 to $30,000 for each of the devices.
  • Extending coverage to additional Medicare patients who might benefit would cost anywhere from $175 million to well over $3 billion a year if they are widely adopted.

The panel is charged with advising the Centers for Medicare and Medicaid Services on whether the evidence warrants the substantial broadening of coverage sought by the makers of the defibrillators, Guidant Corp.

Officially, Medicare doesn't directly consider cost in making coverage decisions. But in this case, the potential costs are so enormous that they can't help but be a factor in deliberations, experts say.

Source: Laurie McGinley and Thomas M. Burton, "Medicare Panel to Debate Use of Defibrillator," Wall Street Journal, February 12, 2003.

For text (WSJ subscription required),,SB1045000408824332583-search,00.html


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