Can Europe afford not to implement evidence-based medicine in heart failure?

Technological change in cardiovascular medicine is extremely rapid and is likely to continue to accelerate. Society, of course, demands that new products and services are clinically effective in combating disease, reducing disability and extending life. Society also requires them to be cost-effective. Within this framework there is a vital need to produce authoritative information to assist in making very important healthcare decisions. A strategy for assessing both the effectiveness and the economics of cardiovascular disease management programmes has four discrete, mutually reinforcing tasks: (1) identifying the technologies that need to be assessed, (2) collecting data on the selected technologies, (3) synthesizing the data collected, and (4) disseminating the information collected. There is no single strategy to prevent a global financial crisis in heart failure care. However, a set of recommendations have been proposed as a means to overcome major obstacles. These recommendations have been elaborated mainly from a practical point of view and, while they are not meant to be exhaustive, they may represent an agenda for action. Future research, and especially experience relating to the economics and outcomes of heart failure care developments, will be of utmost interest and may act as a basis for further healthcare decisions.