Monday, July 09, 2007

Is This Atrial Fibrillation Treatment Worth its Cost?

A New York Times article by Barnaby J. Feder talks about cost burden of a procedure (called ablation) used to treat atrial fibrillation. Atrial fibrillation is a heart condition characterized by irregular heart beat and increased risk of stroke for the people afflicted by it. This condition afflicts 2.2 million people in the US.
There are many otherwise healthy patients whose life is severely affected by atrial fibrillation. Many times, their atrial fibrillation does not respond to medicines. Potential cure from ablation procedure is a God-send to such patients.
This Times article investigates how this- increasingly frequently performed procedure- is further straining the limited health care resources. I think this question is being raised because of the following reasons:
- We know that atrial fibrillation is a recurrent disease regardless of what we do. The promise of a cure with ablation has not been delivered yet.
- The results of ablation have not been consistent. Some facilities have reported phenomenal results, but the results can vary to an uncomfortable extent between different facilities
- Many patients with atrial fibrillation tend to have many co-existent medical problems which may adversely affect survival regardless of presence of atrial fibrillation. The question in such cases is: should we try to- or can we- cure atrial fibrillation?
The real (although non-PC) question is: is this procedure being driven by monetary incentives? I think the reason that more of these procedures are being performed is that more than 1 in 150 people in the US have this problem. It is only likely to get worse as the population ages. As this (ablation) technology goes through its usual maturity period, the cost of procedure will inevitably come down. With time, this technique will also find its right place in the treatment of right kind of patients. The question – whether the cost of this procedure is worth it- is harder to answer. Before we get to that part of the discussion, we will have to start discussion on another non-PC topic- healthcare rationing. through action


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