Reducing pacemaker costs while preserving choice: a partnership that worked.

Over the last ten years, separate and repeated attempts by Cardiology Management, Materials Management, and physicians to effectively reduce pacemaker costs had led to limited successes of short duration. Issues of physician choice, clinical application of advancing technology and long-term relationships with a variety of vendor representatives had usually conspired to overwhelm any incremental inroads into manufacturers' pricing structures. A collaborative review of past practices resulted in the creation of a multi-disciplinary task force charged with two goals: maintain physician choice and reduce costs. In the resulting process, no manufacturer was eliminated, vendors accepted all of the risks and received no guarantees of market share, and device specifications were matched to clinical indications in a preferred device matrix. The task force met both of its goals as evidenced by a 18.9% decrease in annual expenditures for pacemakers and by a 27% shift in device use based upon physician choice.