Year: 1986
Type: article
Abstract: CARDIAC PACING is only a quarter of a century old, and during its first 20 years it enjoyed meteoric and unbridled growth.During the past 5 years, however, the practice has been attacked from within by criti- cisms of its medical applications and from without by accusations of flamboyant advertising, excessive prof- its, unacceptable management practices, and, in some cases, fraud.These claims have been made into political issues, with the "industrial-professional complex" being accused of wasting three billion dollars a year.' To identify important developments in the field and, at the same time, to determine rationally whether any justification exists for some of the accusations, it is necessary to review the state of the art of pacing and examine the facts objectively.Only then can one ap- preciate the extent of the existing problems and con- template their potential solutions.The pacing industry is small.The largest manufac- turer (Medtronic, Inc.) ranks 496th in the "Fortune 500" list of American industries, with net pacemaker sales worldwide of approximately $280 million.The total cost of pacing includes devices, hospitalization, physicians' fees, and follow-up.In 1981 approximately 118,000 pulse generators were implanted in the United States.2The major pacemaker manufacturers estimate that the figure for 1985 will be 90,000.Of the approximately 500,000 patients with permanent pace- makers living in the United States, about 90% are being followed by pacemaker surveillance services or by their own private physicians.Medicare, which re- imburses individuals who are age 65 or older for medical services, pays approximately $775 million annual- ly for pacing therapy.Because each primary implantation or pulse-generator replacement involves the purchase of a device, information about costs and
Source: Circulation
Authors: V Parsonnet, A D Bernstein
Institution: École Polytechnique
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2040307192