The current business model for selling and servicing implantable cardiac rhythm management devices is broken.  The model, used by Medtronic, St. Jude, Boston Scientific, and others, is not sustainable in the current health care environment.  It will be even less sustainable as health care evolves in the future.

Pfizer recently lost patent protection on its lead drug, Lipitor.  In 2010 Lipitor had sales of $10.7B, which represented 15.8% of Pfizer's revenue.  The ramifications will be widespread.