after pharmaceutical trial, if the new compound works, sometimes you have option to continue treatment. here “continuation of treatment” would be just leaving device in place, you don’t have to supply new stuff. the real problem becomes maintenance when there’s no one to do it. yes, it’s unsupported, but it works, as long as it works - maybe there should be a legal option for patient to leave it be in such case

“who should come up with the money” is an issue that comes up even with post-trial therapy using normal boring small molecule drugs (much cheaper per patient)