scholarly journals Modeling in Early Stages of Technology Development: Is an Iterative Approach Needed? Comment on "Problems and Promises of Health Technologies: The Role of Early Health Economic Modeling"

Author(s):  
Michael F. Drummond

A recent paper by Grutters et al makes the case for early health economic modeling in the development of health technologies. A number of examples of the value of early modeling are given, with analyses being performed at different stages in the development of several non-drug health technologies. This commentary acknowledges the contribution of the paper by Grutters et al and argues for an iterative and integrated approach to early modeling, assessing the cost-effectiveness of the technology, the value of future research and the interaction with the manufacturer’s pricing and revenue expectations.

Author(s):  
Conor Teljeur ◽  
Máirín Ryan

Abstract This commentary considers the positive and negative consequences of early economic modelling and explores potential future directions. Early economic modelling offers device manufacturers an opportunity to assess the potential value of an innovation at an early stage of development. Early modelling can direct resources into potentially viable technologies and reduce investment in technologies with limited prospect of value. However, it is unclear whether early modelling is sufficiently specific to identify innovations with low value. It may be that early modelling is more useful for directing data gathering to reduce decision uncertainty. Early modelling is of primary benefit to the manufacturer and may have both positive and negative consequences for reimbursement processes that should be considered


Author(s):  
Carlo Federic ◽  
Aleksandra Torbica

In this commentary, we discuss early stage assessments of innovative medical technologies both in terms of methods applied as well as their use in healthcare decision-making. We argue that cost-effectiveness alone may be too reductive if taken as the only decision rule, and it would benefit from being used within a broader evaluation framework. We discuss innovative methods which may contribute to better estimate the potential costs and consequences of a technology in the absence of solid clinical data, as frequently the case in early assessments. Finally, we comment on the potential synergies which may take place should early economic models be used not only by technology developers alone but as a negotiating base during early dialogues with health technology assessment (HTA) bodies.


Author(s):  
Pascale Lehoux ◽  
Hudson Silva

Grutters et al show that economic assessments can inform the development of new health technologies at an early stage. This is an important contribution to health services and policy research, which implies a "shift away" from the more traditional forms of academic health economic modeling. Because transforming established disciplinary traditions is both valuable and demanding, we invite scholars to further the discussion on how the value of health innovations should be appraised in view of today’s societal challenges.


Author(s):  
Andrew Partington ◽  
Jonathan Karnon

In a review recently published in this journal, Grutters et al outline the scope and impact of their early health economic modelling of healthcare innovations. Their reflections shed light on ways that health economists can shift-away from traditional reimbursement decision-support, towards a broader role of facilitating the exploration of existing care pathways, and the design of options to implement or discontinue healthcare services. This is a crucial role in organisations that face constant pressure to react and adapt with changes to their existing service configurations, but where there may exist significant disagreement and uncertainty on the extent to which change is warranted. Such dynamics are known to create complex implementation environments, where changes risk being poorly implemented or fail to be sustained. In this commentary, we extend the discussion by Grutters et al on early health economic modelling, to the evaluation of complex interventions and systems. We highlight how early health economic modelling can contribute to a participatory approach for ongoing learning and development within healthcare organisations.


Author(s):  
Hansoo Kim ◽  
Stephen Goodall ◽  
Danny Liew

Grutters et al recently investigated the role of early health economic modelling of health technologies by undertaking a secondary analysis of health economic modelling assessments performed by their group. Our commentary offers a broad perspective on the potential utility of early health economic modelling to inform health technology assessment (HTA) and decision-making around reimbursement of new health technologies. Further we provide several examples to compliment Grutters and colleagues’ observations.


2019 ◽  
Vol 8 (10) ◽  
pp. 575-582 ◽  
Author(s):  
Janneke P.C. Grutters ◽  
Tim Govers ◽  
Jorte Nijboer ◽  
Marcia Tummers ◽  
Gert Jan van der Wilt ◽  
...  

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.


2016 ◽  
Vol 23 (3) ◽  
pp. 600 ◽  
Author(s):  
Uba Backonja ◽  
Nai-Ching Chi ◽  
Yong Choi ◽  
Amanda K Hall ◽  
Thai Le ◽  
...  

Background: Health technologies have the potential to support the growing number of older adults who are aging in place. Many tools include visualizations (data visualizations, visualizations of physical representations). However, the role of visualizations in supporting aging in place remains largely unexplored.Objective: To synthesize and identify gaps in the literature evaluating visualizations (data visualizations and visualizations of physical representations), for informatics tools to support healthy aging.Methods: We conducted a search in CINAHL, Embase, Engineering Village, PsycINFO, PubMed, and Web of Science using a priori defined terms for publications in English describing community-based studies evaluating visualizations used by adults aged ≥65 years.Results: Six out of the identified 251 publications were eligible. Most studies were user studies and varied methodological quality. Three visualizations of virtual representations supported performing at-home exercises. Participants found visual representations either (a) helpful, motivational, and supported their understanding of their health behaviors or (b) not an improvement over alternatives. Three data visualizations supported understanding of one’s health. Participants were able to interpret data visualizations that used precise data and encodings that were more concrete better than those that did not provide precision or were abstract. Participants found data visualizations helpful in understanding their overall health and granular data.Conclusions: Studies we identified used visualizations to promote engagement in exercises or understandings of one’s health. Future research could overcome methodological limitations of studies we identified to develop visualizations that older adults could use with ease and accuracy to support their health behaviors and decision-making.


2014 ◽  
Vol 22 (3) ◽  
pp. 253-262 ◽  
Author(s):  
Joran Lokkerbol ◽  
Dirk Adema ◽  
Pim Cuijpers ◽  
Charles F. Reynolds ◽  
Richard Schulz ◽  
...  

2019 ◽  
Vol 11 (17) ◽  
pp. 4780 ◽  
Author(s):  
Mamadou Sissoko ◽  
Melinda Smale ◽  
Annick Castiaux ◽  
Veronique Theriault

Although it is commonly accepted that farmers’ participation in the process of technology development can improve adoption rates, few studies have tested this relationship. We tested the role of farmers’ participation in the decision to adopt new sorghum varieties in the Sudan Savanna of Mali. We applied a conditional mixed-process method to data collected from 496 households in 58 villages the national agricultural research program (Institut d’Economie Rurale) and International Crops Research Institute for the Semi-Arid Tropics (ICRISAT) worked through farmer organizations to test varieties in farmer-managed trials and implement seed production activities. We found that the intensity of participation positively affects adoption rates on household plots. Intensity of participation was measured as the ratio of participants in the household to the total number of participants in the village. Several plot manager and household characteristics influence adoption, including education and proximity of the plot manager with head of household, household assets, and labor availability. This study draws attention to the importance of farmers’ participation as a sustainable practice that can stimulate the adoption of new technology and, in doing so, enhance food security. Future research should explore the intrahousehold dynamics of farm input adoption, and the role of different forms of participation in the innovation process.


2019 ◽  
Vol 57 (11) ◽  
pp. 1712-1720
Author(s):  
Anouck Kluytmans ◽  
Jaap Deinum ◽  
Kevin Jenniskens ◽  
Antonius Eduard van Herwaarden ◽  
Jolein Gloerich ◽  
...  

Abstract Background Choosing which biomarker tests to select for further research and development is not only a matter of diagnostic accuracy, but also of the clinical and monetary benefits downstream. Early health economic modeling provides tools to assess the potential effects of biomarker innovation and support decision-making. Methods We applied early health economic modeling to the case of diagnosing primary aldosteronism in patients with resistant hypertension. We simulated a cohort of patients using a Markov cohort state-transition model. Using the headroom method, we compared the currently used aldosterone-to-renin ratio to a hypothetical new test with perfect diagnostic properties to determine the headroom based on quality-adjusted life-years (QALYs) and costs, followed by threshold analyses to determine the minimal diagnostic accuracy for a cost-effective product. Results Our model indicated that a perfect diagnostic test would yield 0.027 QALYs and increase costs by €43 per patient. At a cost-effectiveness threshold of €20,000 per QALY, the maximum price for this perfect test to be cost-effective is €498 (95% confidence interval [CI]: €275–€808). The value of the perfect test was most strongly influenced by the sensitivity of the current biomarker test. Threshold analysis showed the novel test needs a sensitivity of at least 0.9 and a specificity of at least 0.7 to be cost-effective. Conclusions Our model-based approach evaluated the added value of a clinical biomarker innovation, prior to extensive investment in development, clinical studies and implementation. We conclude that early health economic modeling can be a valuable tool when prioritizing biomarker innovations in the laboratory.


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