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Ann Thorac Surg 2001;71:S195-S198
© 2001 The Society of Thoracic Surgeons

Session 5: economics of devices

The cost of long-term LVAD implantation

Alan J. Moskowitz, MDa,b, Eric A. Rose, MDa,b, Annetine C. Gelijns, PhDa,b

a International Center for Health Outcomes and Innovation Research, Departments of Surgery and Medicine, College of Physicians and Surgeons and the Joseph L. Mailman School of Public Health, Columbia University, New York, New York, USA
b New York Presbyterian Hospital, New York, New York, USA

Address reprint requests to Dr Moskowitz, International Center for Health Outcomes and Innovation Research, Columbia University, Harkness Pavilion, Rm 756, 180 Fort Washington Ave, New York, NY 10032
e-mail: ajm4{at}columbia.edu

Presented at the Fifth International Conference on Circulatory Support Devices for Severe Cardiac Failure, New York, NY, Sept 15–17, 2000.

Abstract

Background. With increasing use of left ventricular assist devices (LVAD) worldwide, the economics of LVAD implantation have become an important focus of concern. Although these devices have high unit costs, they are the only hope for survival for a large group of terminally ill patients and are likely to have an expansion in indications for use.

Methods. We calculated the costs associated with long-term LVAD implantation. We used the ratio of cost-to-charges method to calculate hospital costs per resource category, market prices for drugs and device, and payments for physician services.

Results. Based on our experience with "bridge-to-transplantation" patients, we estimated average first-year costs to be $222,460 including professional fees and $192,154 excluding professional fees. The latter figure is comparable to average first-year costs for cardiac transplantation, which is $176,605 without professional fees at our institution.

Conclusions. The costs of LVAD therapy will change after the first year of implantation, and device reliability and longevity will be important factors in determining these costs. Should the costs of LVAD therapy continue to track those of cardiac transplantation, devices will be cost-effective only if they offer similar efficacy to cardiac transplantation.




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