Controlling the cost of healthcare is seldom black and white. How much should we be willing to pay to briefly extend the lives of a few very sick people? For instance, the FDA just approved a mechanical heart for patients who have only a month to live, suffer from failure of both chambers of the lower heart, and aren't eligible for a heart transplant.. The AbioCor system consists of a 2-pound mechanical heart implanted in the chest. The patient's diseased heart is removed during implantation. A power transfer coil across the skin that powers the system and recharges the internal battery from the outside. A controller and battery implanted in the belly. The controller adjusts the artificial heart's pumping rate. The internal battery allows the patient to be free from all external connections for up to 1 hour. During sleep and while batteries are being recharged, the system can be plugged into a normal electrical outlet.
In clinical trials, the device extended patients' lives by only four and a half months, on average. One patient survived 17 months, another 10 months. Only one patient was able to go home. "It is important to recognize that right now the device is a niche device targeted to an extremely sick heart failure population," Bram Zuckerman, MD, director of the FDA's heart device division says. "The vast majority of these patients are bed bound, extremely short of breath, and hooked up to multiple intravenous medications. Just the ability to ambulate, to clearly communicate with loved ones, to take excursions out of the hospital, and to celebrate important family events, were -- in the eyes of the patients and family members -- seen to be an improvement."
I suppose the main reason for going to these great lengths for very little incremental benefit is that these highly restricted applications will give Abiomed, the manufacturer of the device (and its competitors), the experience they need to build smaller, smarter, more elegant artificial hearts for a wider audience at lower cost.
How do you feel about it? Do you think we should continue a long this path?