evidence: To learn more, Commonwealth Fund–supported researchers compared the prices that large hospitals in the U.S. and four E.U. countries — France, Germany, Italy, and the United Kingdom — reported paying for cardiac implants between 2006 and 2014. The study, published in Health Affairs, specifically focused on two types of implants: cardiac stents and cardiac rhythm management devices. All European prices were converted to U.S. dollars. [...] - Prices of both drug-eluting and metal cardiac stents declined during the study period in four of the five countries. However, prices of cardiac defibrillator devices remained more stable. [...] The variation in prices paid for similar and identical cardiac implants suggests that device effectiveness is not the only factor influencing price setting. Price variation cannot be explained solely by differences in regulatory requirements: prices varied among E.U. countries, which operate in a single harmonious market with no trade barriers. In-country price differences suggest that various aspects of the purchasing relationship between hospitals and manufacturers may be contributing to the difference seen. Past research has pointed to factors such as physician preference for using certain devices. Competition and other market factors may also play a role. Additional research is needed to pinpoint mechanisms that policymakers and others can use to help control device prices.