Medical Device Cost Drivers (and Other Simplifications)

In response to the article, "Medical Devices Driving Up Heart Care Costs", see link, I could not help but have a problem with it.

Here was my shared comment on Google Reader:

I abhor simplistic analyses. The increased cost of treating coronary artery disease has gone up 1.5% per year (after adjustment for inflation) and the similar increase for treatment of chronic heart failure is 2.3% per year. While I can't speak to the device cost in congestive heart failure, I can say that the average unit price of drug-eluting stents* is declining about 6.3% per year, so, if overall costs are being addressed on a per patient basis, then the increased cost is in physician fees, hospital fees, healthcare insurance — many other sources. If, however, these increased costs are in the aggregate (i.e., not per patient), then the increase in cost is due to a growing caseload of patients being treated with these technologies (and taking on physician/hospital/insurance costs), the alternative for which is either (a) lower quality of life or (b) death. It's always so much easier to focus on medical device costs rather than death.

If you don't understand the full picture, then you are clearly going to make a mistake by disregarding important considerations outside your frame of reference.  And these days, the most prevalent frame of reference seems to be that "medical devices drive up costs", so this is not surprising.  It seems rather obvious that you cannot legitimately disregard the overall cost considerations (medical device prices are declining) or the real driving force to higher costs — healthcare demand or the drive for higher quality of life.

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