Economic methods used in health technology assessment

Health technology assessment of medical devices: current landscape, challenges, and a way forward

“…For example, a double-blind procedure was usually hard to implement due to differences in the appearance of medical devices • Another reason was that implantable medical devices require informed consent from a patient before implantation as they involve an invasive procedure • There was a lack of infrastructure, e.g., qualified clinical centers and trained professionals to conduct RCTs for medical devices Device-user interaction Unlike drugs, the performance of medical devices sometimes depends on their users' experience as well • The so-called "learning curve": the launch of a medical device is followed by a training or initiation period during which healthcare professionals learn how to handle the technology. As healthcare professionals gain more experience over time, they were able to grasp the subtle differences that affected the overall clinical benefits, thus making the best use of the technology • The learning curve had inevitably interfered with the HTA of medical devices because the comparative effectiveness between newly-launched and traditional products was a function of the product itself and operators' proficiency, which was hard to quantify • The clinical adoption of medical devices may also associate with wider impact of organizational change, for instance, there may be a need for additional training of physicians or other health professionals, or the introduction of a given device may require a hospital to reorganize services to accommodate the new technology or procedure [3][4][5][6][7][8][9][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Short product life cycle and quick upgrade Unlike drugs, the product life cycle of medical devices is usually as short as one to 3 years • The key contributing factor was that medical devices undergo continuous improvement and incremental innovation, which might result in the existence of various models and specifications within a single product class • Recognizing the iterative nature of medical devices, regulatory agencies exempted such variants from rigorous clinical trials as long as the safety of the new variant was the same as the original. As a result, manufacturers had neither enough time to collect data for economic evaluations nor an incentive to invest in clinical research and HTA • From researchers' perspective, the short life cycle required the...…”

From Health Technology Assessment to Health Technology Sustainability

“…The analysis in Section 2 shows that the most widespread methodologies for health assessment are limited to one-dimensional measurements of efficiency, inspired by the simple relationship between costs and results. Among them, the most common evaluation methods used for the assessment of new medical devices or drugs are the cost-effectiveness-analysis (CEA) and the cost-utility analysis (CUA) [43].…”

Multicomponent syntheses of functional chromophores

“…As an inevitable side reaction a twofold addition of the ferrocenyl moiety results in the formation of 3,4-dihydropyridines 4 as byproducts. 19 The cyclic voltammograms of the aromatic compound 3a reveals a single reversible Nernstian oxidation potential at around 215 mV deriving from the ferrocenyl substituent. Expectedly a second oxidation potential can be detected for dihydropyridine 4a, originating from the second ferrocenyl moiety.…”