Championing Effectiveness Before Cost-Effectiveness.

T he proliferation of costly therapies has led to an increased focus on value. In the treatment of patients with advanced heart failure (HF), one such expensive intervention, CardioMEMS (CardioMEMS Heart Failure System, St. Jude Medical Inc., Atlanta, Georgia), is a permanently implanted device to monitor pulmonary artery pressure and enable adjustments in therapy that could avert the need for hospitalization. CardioMEMS was tested in the CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients) trial, a randomized, single-blind multicenter study led by the founder of the company. It included 550 patients with New York Heart Association (NYHA) functional class III HF with $1 HF-related hospitalization in the past year (1). All patients underwent implantation with the CardioMEMS device. Treatment patients had specific pulmonary artery pressure targets and