Health Affairs, 24, no. 1 (2005): 52-54 doi: 10.1377/hlthaff.24.1.52 © 2005 by Project HOPE	New Online   Senate Health Reform Bill   Rewarding Providers   Public Option Policy Brief   Health Reform & Abortion   Delivery System Reform

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PERSPECTIVE

Implantable Cardioverter Defibrillators: An Excellent Case Study

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. [Full Text] [PDF]