The Artificial Heart: Costs, Risks, and Benefits—An Update

Abstract

For several decades, major advances in medicine have increased dramatically our ability to prevent, diagnose, and manage a wide variety of chronic and acute health problems. However, medical innovations also pose significant economic, social, and ethical questions. How do we best utilize scarce medical resources? How do we balance anticipated benefits against the dollar cost or associated risk? What is the impact on total health care spending now and in future years? As concern over these issues grows concomitant with increased health care spending, technology assessment is often promoted as a method for determining whether a biomedical innovation should be encouraged to disseminate rapidly in order to maximize its benefits to individual patients, or constrained to develop slowly in order to minimize collective costs or risks. But, the art and practice of evaluating medical technologies, especially innovations still in the research and development phase, are not well developed (6;8;11;14;16;34;35).