Cost-Effectiveness and Reimbursement

Growing Crisis of Coronary Artery Disease and Heart Failure

Cardiovascular diseases are the most prevalent and costly disease categories, with more than $363.4 billion in direct and indirect costs in the U.S. in 2016-2017, according to the American Heart Association1. Heart failure is the leading cause for medical readmissions among the Medicare population. One of every four acute heart failure patients is readmitted within 90 days of initial admission.

  • >15M

    people with coronary artery disease (CAD) and more than 875,000 deaths per year from CAD2

  • 65+

    year-old population expected to increase an additional 44% by 2030. Mortality also increasing in 45-65 year-old population3

  • ~50%

    cardiogenic shock mortality rate for last 20+ years4 without Impella heart pumps

Impella therapy demonstrates significant cost savings and cost-effectiveness for payers and providers

Impella is Associated with Reduced Mortality and Cost

Studies show the use of percutaneous ventricular assist devices (PVADs), including Impella, is particularly cost-effective.

  • 29-47% reduction in adverse events at 90 days (death, stroke, MI, and/or repeat revascularization)5, 6
  • 58% reduction in 30-day mortality for patients with CAD7
  • 44% lower in-hospital mortality for patients with higher comorbidities vs. IABP8

Impella Reduces Length of Stay and Readmissions

Several studies, including systematic reviews of multiple cost-effectiveness publications, demonstrate that Impella use is associated with a reduction in length of stay for patients, with a greater opportunity for benefit as the illness level increases.

  • 52% reduction in repeated admission for revascularization at 90 days9
  • Impella is associated with a reduction in hospital stays ranging from 2-12 days.9, 10 In the PROTECT II randomized controlled trial, there was a two-day reduction in hospital days.9 More emergent settings show a reduction in hospital days ranging from 2-12 days.9

Explore the Education Library


Improved Outcomes with Contemporary Practices in PROTECT III

Jeffrey Moses, MD, discusses the improved outcomes with contemporary practices seen in the PROTECT III study of Impella-supported high-risk PCI.


Comparing Impella® to ECMO in AMICS

Lemor et al. demonstrate better clinical outcomes, fewer complications, shorter hospital stay, and lower cost with Impella compared to ECMO in AMICS.

Reimbursement Resources

Explore a PDF relating to program cost-effectiveness

Learn More

Explore a PDF relating to coding and billing



  1. Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. (2019). Circulation.
  2. Einarson, et al. (2018). Cardiovasc Diabetol. 17, 83.
  3. Sidney, S., et al. JAMA Cardiol.  
  4. Jeger, et al. (2008). Ann Intern Med.
  5. O’Neill, W.W., et al. (2012). Circulation, 126(14), 1717-1727.
  6. Dangas, G.D., et al. (2014). Am J Cardiol, 113(2), 222-228.
  7. Stretch, R., et al. (2014). J Am Coll Cardiol, 64(14), 1407-1415.
  8. Al-Khadra, et al. (2019). CCI, 95(3), 503-512.
  9. Maini, B., et al. (2014). Expert Rev Pharmacoecon Outcomes Res, 14(3), 403-416.
  10. Gregory, D., et al. (2013). Am Health Drug Benefits, 6(2), 88-99.