A University of Iowa study raises questions about the four-point-six billion dollars spent every year nationwide on certain types of devices for heart patients. Study lead author Doctor Peter Cram, a U-of-I internal medicine professor, says many older Americans are getting livesaving devices called I-C-Ds, implantable cardioverter defibrillators.
Cram says 40-thousand patients a year through Medicare get I-C-Ds at a rate of 40-thousand dollars each. The study says there may be a better way, or a different way, to allocate the money. I-C-D’s are about the size of a pager and are implanted. Another option is the briefcase-sized automated external defibrilator, or A-E-D, which costs about two-thousand dollars.
Cram says A-E-Ds are less-expensive but are also less effective, since someone has to be around to use the device on the patient. He says for certain patients, Medicare might be better off telling some lower-risk heart patients to get the A-E-D instead of an I-C-D and that “Medicare as a whole or the country as a whole might be better off.”
Cram says for the same total cost, it might be reasonable for Medicare to consider providing the less expensive defibrillator to many more Medicare beneficiaries, though he says it opens a new host of questions. He says “Are there certain people whose hearts are really pretty good, not perfect but they’re good enough, that they could have an A-E-D? That’s where the tough decisions are going to need to be made in Washington and at the insurance companies as well.”
Cram says “Medicare is facing a budget crunch. The U.S. population is aging. Budgets are tight. Medicare needs to be innovative and think carefully about how to maximize the value it provides to American seniors.” The study was published in the June issue of the journal Value in Health.