Pricey Implantable Defibrillators Worth It - Study

BOSTON (Reuters) - They may cost about $28,000 each, and 500,000 people in the United States could benefit from them, but implantable defibrillators that automatically shock an erratic heart into beating normally justify the cost, a study showed on Wednesday.

The finding, published in The New England Journal of Medicine, supports a January decision by the U.S. government to pay for the devices in Medicare recipients whose heart disease puts them at risk of sudden death.

The devices, known as implantable cardioverter defibrillators, are already widely accepted as a cost-effective way of protecting the lives of people who barely escaped death when their hearts essentially stopped beating.

The new study, led by Gillian Sanders of Duke University, was designed to see if the devices were cost-effective in less extreme cases.

"These are patients with heart disease whose life expectancy isn't that great," she told Reuters. "This study is coming back and saying this is good value for the money."

U.S. Vice President Dick Cheney had the device implanted in his chest in June 2001 to guard against potentially dangerous heart rhythms.

By looking at the costs associated with the procedure and using eight existing studies to assess the devices, the researchers concluded that the defibrillators added two to six years of life to a typical patient.

When all expenses were considered, installing a defibrillator costs $34,000 to $70,000 for each additional year of life.

She acknowledged that because a half-million Americans might be candidates for the devices, paying for them is a pricey proposition.

"They're expensive devices. But given the increase in life expectancy, they're a good value and comparable to other things" covered by insurance companies and the federal Medicare program.

Kidney dialysis, for example, costs $50,000 for each additional year of life earned, heart bypass surgery costs about $18,000, treating high blood pressure costs $5,000 to $50,000, and giving statin drugs to bring down cholesterol levels and prevent heart attacks costs about $21,000, she said.

"It's still a dilemma, even though it's a good value," said co-author Douglas Owens of the Veterans Affairs Palo Alto Health Care System. "The total number of dollars that are going to go into this is projected to be very large, so there's no question it will be a sizable expenditure."

Sanders said further studies may reduce the cost if doctors discover how to predict which patients are most likely to need the devices, which are usually implanted during an overnight stay in the hospital.