scholarly journals Transforming Disciplinary Traditions Comment on "Problems and Promises of Health Technologies: The Role of Early Health Economic Modeling"

2019 ◽  
Author(s):  
Pascale Lehoux ◽  
Hudson Silva
Keyword(s):  
Health Economic ◽  
Early Stage ◽  
Policy Research ◽  
Economic Modeling ◽  
Health Technologies ◽  
Societal Challenges ◽  
Health Innovations ◽  
Early Health ◽  
Value Of Health

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.

scholarly journals 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"

2019 ◽  
Author(s):  
Conor Teljeur ◽  
Máirín Ryan
Keyword(s):  
Health Economic ◽  
Early Stage ◽  
Data Gathering ◽  
Economic Modeling ◽  
Economic Modelling ◽  
Negative Consequences ◽  
Health Technologies ◽  
Stage Of Development ◽  
Early Health

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

scholarly journals 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"

2020 ◽  
Author(s):  
Carlo Federic ◽  
Aleksandra Torbica
Keyword(s):  
Health Economic ◽  
Early Stage ◽  
Economic Modeling ◽  
Evaluation Framework ◽  
Economic Modelling ◽  
Health Technologies ◽  
Innovative Methods ◽  
Healthcare Decision Making ◽  
Early Health

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.

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"

2019 ◽  
Author(s):  
Michael F. Drummond
Keyword(s):  
Health Economic ◽  
Technology Development ◽  
Integrated Approach ◽  
Economic Modeling ◽  
Future Research ◽  
Iterative Approach ◽  
Health Technologies ◽  
Early Health ◽  
The Cost

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.

scholarly journals 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"

2020 ◽  
Author(s):  
Andrew Partington ◽  
Jonathan Karnon
Keyword(s):  
Health Economic ◽  
Complex Interventions ◽  
Healthcare Services ◽  
Economic Modelling ◽  
Learning And Development ◽  
Health Technologies ◽  
Significant Disagreement ◽  
Early Health ◽  
Health Economic Modelling

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.

scholarly journals The Potential for Early Health Economic Modelling in Health Technology Assessment and Reimbursement DecisionMaking Comment on "Problems and Promises of Health Technologies: The Role of Early Health Economic Modeling"

2020 ◽  
Author(s):  
Hansoo Kim ◽  
Stephen Goodall ◽  
Danny Liew
Keyword(s):  
Health Economic ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Economic Modelling ◽  
Broad Perspective ◽  
Health Technologies ◽  
Early Health ◽  
Health Economic Modelling

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.

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

2019 ◽  
Vol 8 (10) ◽  
pp. 575-582 ◽  
Author(s):  
Janneke P.C. Grutters ◽  
Tim Govers ◽  
Jorte Nijboer ◽  
Marcia Tummers ◽  
Gert Jan van der Wilt ◽  
...  
Keyword(s):  
Health Economic ◽  
Cost Effectiveness ◽  
Cost Savings ◽  
Cost Effective ◽  
Economic Modeling ◽  
Potential Cost ◽  
Health Technologies ◽  
Potential Benefits ◽  
Secondary Analyses ◽  
Early Health

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.

scholarly journals Clinical biomarker innovation: when is it worthwhile?

2019 ◽  
Vol 57 (11) ◽  
pp. 1712-1720
Author(s):  
Anouck Kluytmans ◽  
Jaap Deinum ◽  
Kevin Jenniskens ◽  
Antonius Eduard van Herwaarden ◽  
Jolein Gloerich ◽  
...  
Keyword(s):  
Health Economic ◽  
Diagnostic Accuracy ◽  
Cost Effective ◽  
Economic Modeling ◽  
Added Value ◽  
Life Years ◽  
Clinical Biomarker ◽  
Early Health ◽  
Aldosterone To Renin Ratio ◽  
Effective Product

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.

scholarly journals Characterizing the Validity and Real-World Utility of Health Technology Assessments in Healthcare: Future Directions Comment on "Problems and Promises of Health Technologies: The Role of Early Health Economic Modelling"

2019 ◽  
Author(s):  
Nadine K. Zawadzki ◽  
Joel W. Hay
Keyword(s):  
Health Economic ◽  
Real World ◽  
Reliability And Validity ◽  
Health Technology ◽  
Economic Modeling ◽  
Economic Evaluations ◽  
Economic Modelling ◽  
Complete Representation ◽  
Health Technologies ◽  
Wide Range

With their article, Grutters et al raise an important question: What do successful health technology assessments (HTAs) look like, and what is their real-world utility in decision-making? While many HTAs are published in peer-reviewed journals, many are considered proprietary and their attributes remain confidential, limiting researchers’ ability to answer these questions. Models for economic evaluations like cost-effectiveness analyses (CEAs) synthesize a wide range of evidence, are often statistically and mathematically sophisticated, and require untestable assumptions. As such, there is nearly universal agreement among researchers that enhancing transparency is an important issue in health economic modeling. However, the definition of transparency and guidelines for its implementation vary. Model registration combined with a linked database of model-based economic evaluations has been proposed as a solution, whereby registered models and their accompanying technical and nontechnical documentation are sourced into a single publicly-available repository, ideally in a standardized format to ensure consistent and complete representation of features, code, data sources, results, validation exercises, and policy recommendations. When such a repository is ultimately created, modelers will not have to reinvent the wheel for every new drug launched or new treatment pathway. These more open and transparent approaches will have substantial implications for model accuracy, reliability, and validity, improving trust and acceptance by healthcare decision-makers.

scholarly journals How Useful Are Early Economic Models? Comment on "Problems and Promises of Health Technologies: The Role of Early Health Economic Modelling"

2019 ◽  
Author(s):  
James Love-Koh
Keyword(s):  
Value Of Information ◽  
Economic Modelling ◽  
Medical Innovation ◽  
Information Analysis ◽  
Statistical Decision ◽  
Continue Development ◽  
Health Technologies ◽  
Early Health ◽  
Health Economic Modelling

Early economic modelling has long been recommended to aid research and development (R&D) decisions in medical innovation, although they are less frequently published and critically appraised. A review of 30 innovations by Grutters et al provides an opportunity to evaluate how early models are used in practice. The evidence of early models can be used to inform two types of decision: to continue development ("stop or go") or to alter future R&D activities. I argue that early models have limited use in stop or go decisions, as less resource and data undermine the reliability of the models’ indicative estimates of cost-effectiveness. Whilst they are far more useful for informing future R&D directions, the best techniques available from statistical decision science, such as value of information analysis, are not regularly used. It is highly recommended that early models adopt these methods to best deal with uncertainty, quantify the potential value of further research, identify areas of study with the greatest potential benefit and generate recommendations on study design and sample size.

Sign in / Sign up

Export Citation Format

Share Document