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PERSPECTIVE
Implantable Cardioverter Defibrillators: An Excellent Case Study
Marshall S. Stanton
Numerous randomized controlled trials have shown that implantable cardioverter defibrillators (ICDs) reduce mortality from sudden cardiac death. Evidence-based medicine can elucidate the benefits of treatment and inform Medicare policy when applied in a consistent and nonselective manner. The use of cost-effectiveness data to determine Medicare coverage—and therefore access to a therapy—involves many practical challenges. Cost-effectiveness analysis may be more useful as a tool to guide marketplace decision making than as a regulatory mechanism. Medicare coverage does not mandate use of a therapy; it allows the discussion to occur between a patient and his or her doctor.
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P. J. Neumann, A. B. Rosen, and M. C. Weinstein
Medicare and Cost-Effectiveness Analysis
N. Engl. J. Med.,
October 6, 2005;
353(14):
1516 - 1522.
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