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QJM Advance Access published online on March 10, 2009

QJM, doi:10.1093/qjmed/hcp025
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© The Author 2009. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Expenditure and value for money: the challenge of implantable cardioverter defibrillators

G. Boriani, M. Biffi, C. Martignani, I. Diemberger, C. Valzania, M. Bertini and A. Branzi

From the Institute of Cardiology, University of Bologna, Bologna, Italy

Address correspondence to Prof. Giuseppe Boriani, Institute of Cardiology, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy. email: giuseppe.boriani{at}unibo.it


   Abstract

Many technology-driven interventions entail considerable financial cost, raising affordability issues. The implantable cardioverter defibrillator (ICD) is a case of an effective primary prevention intervention with high initial costs that is capable of delivering long-term population benefits. At first glance, such interventions may provoke diffidence, if not active resistance, due to the financial burdens which inevitably accompany their widespread adoption. In this article, we review the available economic tools that can help address the ICD cost issue. We think awareness of such knowledge may facilitate dialogues between physicians, administrators and policymakers, and help foster rational decision-making.


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