Problems and Promises of Health Technologies: The Role of Early Health Economic Modeling

Abstract

Background: To assess whether early health economic modeling helps to distinguish those healthcare innovations that are potentially cost-effective from those that are not potentially cost-effective. We will also study what information is retrieved from the health economic models to inform further development, research and implementation decisions. Methods: We performed secondary analyses on an existing database of 32 health economic modeling assessments of 30 innovations, performed by our group. First, we explored whether the assessments could distinguish innovations with potential cost-effectiveness from innovations without potential cost-effectiveness. Second, we explored which recommendations were made regarding development, implementation and further research of the innovation. Results: Of the 30 innovations, 1 (3%) was an idea that was not yet being developed and 14 (47%) were under development. Eight (27%) innovations had finished development, and another 7 (23%) innovations were on the market. Although all assessments showed that the innovation had the potential to become cost-effective, due to improved patient outcomes, cost savings or both, differences were found in the magnitude of the potential benefits, and the likelihood of reaching this potential. The assessments informed how the innovation could be further developed or positioned to maximize its cost-effectiveness, and informed further research. Conclusion: The early health economic assessments provided insight in the potential cost-effectiveness of an innovation in its intended context, and the associated uncertainty. None of the assessments resulted in a firm ‘no-go’ recommendation, but recommendations could be provided on further research and development in order to maximize value for money.

It’s Not the Model, It’s the Way You Use It: Exploratory Early Health Economics Amid Complexity Comment on "Problems and Promises of Health Technologies: The Role of Early Health Economic Modelling"

“…1 Such "… broader criteria were not quantified" in their early health economic modelling, but they noted that these effects "… may limit the commercial viability of an innovation. " 1 The health services into which complex interventions are implemented are themselves, complex-adaptive systems. Such systems are characterised by interacting stakeholders, who actively pre-empt, adapt and influence the technical and social developments associated with an intervention.…”

“…5 Grutters et al reported that their early health economic modelling helped to identify and pre-empt challenges; interestingly though however, only one of the 33 assessments resulted in further research into the implementation setting (ie, usual care). 1 In the context of complex systems, there may be benefit in also modelling the effectiveness of existing technologies in situ, to better understand aspects of current care pathways with the greatest capacity for improvement, to inform the design of new delivery models.…”

“…Following discussions between the authors, AP wrote the first draft of the manuscript, followed by an iterative process of editing and commenting. 1 Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA, Australia. 2 Macquarie University Centre for the Health Economy, Macquarie University, Macquarie Park, NSW, Australia.…”

Expanding the Role of Early Health Economic Modelling in Evaluation of Health Technologies Comment on "Problems and Promises of Health Technologies: The Role of Early Health Economic Modeling"

“…[5][6][7][8] For example Hartz and colleagues argue that early health economic modelling may support technology developers by providing relevant insights on strategic R&D decision-making, pre-clinical preliminary market assessments, go/no-go decisions and identification of potentially successful projects, development of future trial design, assessment of future reimbursement and pricing scenarios and price determination. 6 The work by Grutters et al, 9 recently published in IJHPM, nicely reports on real case studies providing interesting insights on how early health economic models have been actually implemented and how they have been used to assess the potential cost-effectiveness and inform further development, implementation and positioning of innovations in clinical practice. The authors disclose and discuss data on previously developed early health economic modelling assessments on 30 innovations conducted by their team, all of which were non-drug technologies.…”

Early Health Economic Modelling – Optimizing Development for Medical Device Developers? Comment on "Problems and Promises of Health Technologies: The Role of Early Health Economic Modeling"

“…Grutters and colleagues described the experience of carrying out early-stage economic models to inform product development. 1 They reviewed 32 evaluations of 30 non-drug innovations that were used to support further development, research and implementation decisions. It is unclear to what extent the findings of the study can be generalised, and perhaps it should be viewed as a pilot study that highlights the potential of early economic modelling.…”