It’s well-established that cholesterol-lowering PCSK9 inhibitors (PCSK9i) are a pricey addition to any heart patient’s medication regimen, climbing to more than $14,000 per year at retail value and $5,000 in out-of-pocket costs—but they are effective.

Ask cardiologists to name the big advances of the past decade, and many point to transcatheter aortic valve replacement (TAVR) and other breakthroughs that are allowing cardiologists to treat structural heart disease with minimally invasive procedures. Looking ahead, some believe that even bigger, broader changes are coming.

Medical device company Medtronic was already projecting a $250 million financial hit due to Hurricane Maria before wildfires in northern California forced it to shut down four facilities in Santa Rosa on Oct. 9. A Medtronic spokesperson said the approximately 840 employees who live in the area have all reported being safe, and the company plans to reopen three of the four plants next week.

In the past 10 years, Medicare has spent more than $1.5 billion in replacing seven types of defective heart devices, according to the HHS Office of the Inspector General. The same report said patients dished out $140 million in out-of-pocket costs.

Hundreds of thousands of children across the U.K. are learning CPR this week in an effort to combat the country’s “stubbornly low” rates of survival for public cardiac arrests.

Noninferiority trials have dramatically increased in number as researchers try to prove new medical devices and drugs are as safe and effective as established therapies. However, the way these studies are designed and interpreted could use a revamp, a pair of reviewers wrote in The New England Journal of Medicine.

Why are people so willing to act following a disaster—whether natural or human-inflicted—but less receptive to requests from blood centers?

There’s an elephant in the room regarding America’s healthcare spending, said Dariush Mozaffarian, a cardiologist and public health scientist from Tufts University. And that elephant is in the shape of cheeseburgers, piles of sodium and bottles of sugary drinks.