Cost effectiveness of artificial organ technologies versus conventional therapy

This panel consisted of researchers, developers, and users of artificial organ technologies, who were brought together to address the critical issue of cost effective use of artificial organs. Cost effectiveness is and continues to be a major consideration to the clinical introduction of emerging medical device technologies. Unfortunately, clear cost effectiveness data are difficult to obtain for artificial organs. Because many recent advances such as mechanical circulatory support are new, these devices typically undergo early clinical trials on severely moribund patients (who are typically more expensive to treat). In addition, significant resources are required for the development of such devices, which is often reflected in the initial cost of the device. The issue of cost effectiveness is further hampered by a lack of acceptable standards and an ongoing widespread controversy over appropriate methods, which often results in what some suggest are questionable outcomes. This panel was brought together to provide a dialogue toward an increased understanding of the issues and to begin to formulate a consensus on what efforts are needed with regard to cost effectiveness. In this way, the various stakeholders (public, patients, insurers, government, etc.) can be better assured that new artificial organ technologies not only offer improved health care for patients, but can be and, in many cases, are cost effective. The following major issues were addressed by the panel: 1) what is cost effective in the absence of conventional therapy; 2) strategies to reduce the cost of bridging to transplantation; 3) the costs for end-stage Status 1 patients; 4) challenges for emerging medical technologies; and 5) design as a factor in cost effectiveness.