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Cost of Medicine: Are High-Tech Medical Devices and Treatments Always Worth It?

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Right on the money. Professor Emanuel from Penn, who teaches a health policy course attributes the bulk of health costs to technology.

Dan of IA 9:58AM July 21, 2012

Your article on the cost effectiveness of medical devices including implantable cardioverter defibrillators (ICDs) (“Cost of Medicine: Are High-Tech Medical Devices and Treatments Always Worth It?” July 10, 2009) accurately addresses the risks of ICDs and provides a broad overview of the topic of comparative effectiveness research (CER), one of many financial factors being considered in today’s health care reform debate. Yet it fails to inform readers of the alternative: the medical consequences for individuals without ICDs and the financial impact they place on this country’s health care system.
Indeed, there are risks associated with ICDs – as with any other medical device or procedure. Those risks however are typically minor when compared to the life-threatening alternative scenarios that could occur without the presence of an ICD. Patients at risk of cardiac arrest are almost always able to return to their normal work, recreational and personal routine following an ICD implant. The same cannot be said for many individuals with untreated chronic and progressive heart failure
We know that ICDs are more than 98 percent effective in restoring the heart’s normal rhythm when a patient suffers sudden cardiac arrest (SCA) and related arrhythmias. ICDs have and will continue to save lives and restore the quality of life for tens of thousands of people. The continued focus of medical providers is to hone the diagnostic tools and guidelines to improve identifying those patients most at risk of SCA. With 300,000+ Americans dying from SCA each year, the discussion should be who are the prime candidates for ICDs, not whether ICDs should be implanted.

Katherine Hobson: You are very right. Your last sentence sums it up -- the emphasis should be on figuring out the prime candidates and providing them medical services, which includes not only weeding out people for whom there is no benefit, but also making sure those who need it get access. Access and disparities in care are problems in most aspects of medicine.

Chris Chiames of DC 9:32AM July 13, 2009

I have had Tesla 3 MRI and proton therapy (prostate) and am certainly glad it is available. It works and is actually already less expensive in the long run, not to mention the elimination of many side and after effects. And, I am sure if you have some kind of tumor that needs proton as opposed to photon radiation and its potential secondary damage, you too will think all this high tech stuff is well worth it. Legal liability is really just a straw man argument in the overall view of things. Surely there has to be some more arguments that can and probably will be used in this "all of a sudden, lets all eliminate high dollar treatment" ad campaign we are seeing spring up nearly everywhere as we get closer to needed health care system examination. I can't help but wonder about the story behind the stories.

jesse farr of TN 11:22PM July 11, 2009

And the article listed just below this one today on the same webpage...? "MRI beats Mammogram at detecting early breast tumors." Gee whiz! I wonder why Americans want their advanced technology?? We can spend billions on high tech military equipment... We can spend billions on high tech communications equipment... Well, we can also spend billions on high tech medical equipment for the "little people..." Which includes most of us reading this article. Sorry, but the money's there in the budget somewhere... "They" just don't want to spend it on us... Too bad. "They," the Congress and other government fatcats, can figure out a way to put a leash on the big health care insurance corporations. Then the real problem will be on it's way to being fixed.

Glenn of VA 1:58PM July 11, 2009

This article gets some credit for at least bringing up the legal liability doctors face, but falls short in fully taking it into account. Not applying many of these new technologies opens physicians to claims of missed and delayed diagnoses, particulalry with breast and other cancers. There can be no meaningful reform of the medical system if it is not accompanied by implementation of legal reform as well.

Chris Miller of ME 3:48PM July 10, 2009

Currently (2009) proton beam therapy is used to treat less than 0.6% of patients in the USA that receive radiation therapy as part of their treatment. Although proton beam therapy is quite visible at this point in time, the relative cost on the healthcare system is therefore actually quite miniscule. Unfortunately, research to decrease the current high cost per individual patient will not occur until after it has been shown that a sufficient number of patients can be treated with the technology thereby justifying the expenditure of resources by manufacturerers and investors. In other words, the technology can not mature and become less expensive without treating some patients now at high individual costs but at a low healthcare system costs.

Michael Moyers of CA 9:22AM July 10, 2009