The economics of advanced biomaterials

A patient who has previously lost an eye through trauma develops a cataract in his remaining eye. Two types of intraocular lens are available for his treatment, one of modest cost, which is effective in all but a few high-risk patients, the other much more expensive, which gives marginally better results on average, but better performance in those with diabetes or glaucoma. Should the higher-cost lens be used even if there is no direct evidence that it will do better in this patient who does not have these conditions, or is it ethically justified to use the lower-cost lens even though failure would result in the total loss of sight? This case is used as the basis of a discussion on the use of high-cost materials and medical devices.