ICDs Reduce Death From Heart Failure
Heart Failure Patients May Benefit From ICDs, but Cost Is an Obstacle
New Candidates for ICDs continued...
Bardy's new study suggests that heart failure patients, especially those who are sick but not completely disabled, are good candidates for ICDs. But he tells WebMD that expanding ICD coverage to include these patients could mean that as many as 1 million Americans could be implanted with ICDs.
Michael Cain, MD, president of the NASPE-Heart Rhythm Society and director of the cardiovascular division at Washington University in St. Louis, tells WebMD that he estimates "400,000 to 1.5 million people [with heart failure] could benefit from ICD implant."
Better Than Medication?
The new study enrolled more than 2,500 patients who were randomly chosen to receive either ICD, treatment with a drug used for arrhythmias called amiodarone, or dummy pills and then followed for almost four years. Bardy says the patients treated with amiodarone did no better than patients receiving dummy pills.
At a news conference, Bardy said the study was specifically designed to have a "broad public health impact" and he contended that results deliver that impact. But when asked about real-world economic impact of those results -- for example, if the Centers for Medicare and Medicaid would loosen current restrictions on Medicare reimbursement for ICDs, Bardy declined to comment.
Sidney C. Smith Jr., MD, professor of medicine and director of the Center for Cardiovascular Science and Medicine, tells WebMD that the results of the study may help the ICD proponents overcome the "resistance" from third-party payers. "My feeling is that the issue is science. When the science shows a patient benefit, cost should not be a barrier. So it may be that we need to find a way to produce cheaper ICDs." Smith was not involved in the study.
The study was sponsored by Medtronic Inc., Wyeth Pharmaceuticals, and the National Heart, Lung and Blood Institute. Medtronic and Wyeth are WebMD sponsors.