Estimation of Value-Based Price for Five High-Technology Medical Devices Approved by a Regional Health Technology Assessment Committee in Italy

Messori, Andrea; Trippoli, Sabrina

doi:10.7759/cureus.24695

Cited by 2 publications

(7 citation statements)

References 21 publications

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“…In our previous article [ 12 ], we emphasized a few points, that are fully confirmed by the present investigation and that we repropose with nearly the same words:…”

Section: Reviewsupporting

confidence: 87%

“…In a previous article [ 12 ], we analyzed a small group of high-technology devices that were consecutively approved in the Tuscany region from January 2020 to December 2021 [ 13 ]. In the present work, we describe a more extensive analysis based on literature data and focused on the experiences of value-based pricing published thus far in the field of medical devices.…”

Section: Introductionmentioning

confidence: 99%

“…A number of national regulatory agencies (e.g., in the United Kingdom, France, Germany, and Canada) have formally adopted algorithms that estimate the value-based price for newly introduced medicines [2,7,8]. To our knowledge, no reports can be found in the literature published thus far that describe any systematic analysis of value-based pricing in the field of medical devices [8][9][10][11][12]. A PubMed search conducted from inception to the present date shows a series of sporadic reports of value-based pricing applied to individual devices, particularly hightechnology ones; among these, numerous reports reflect a research project sponsored by the manufacturer [8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

“…To our knowledge, no reports can be found in the literature published thus far that describe any systematic analysis of value-based pricing in the field of medical devices [8][9][10][11][12]. A PubMed search conducted from inception to the present date shows a series of sporadic reports of value-based pricing applied to individual devices, particularly hightechnology ones; among these, numerous reports reflect a research project sponsored by the manufacturer [8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Estimation of Value-Based Price for 48 High-Technology Medical Devices

Hyeraci¹,

Trippoli²,

Rivano³

et al. 2023

Cureus

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Value-based price is estimated quite frequently for medicines, but its application to medical devices is scarce. While some reports have been published in which this parameter has occasionally been determined for devices, no large-scale application has yet been reported. Our objective was to pursue a systematic analysis of the literature published on value-based prices of medical devices. Pertinent papers were selected upon the criterion that the value-based price was reported for the device examined. The real prices of the devices were compared with their values of value-based price and the ratios between real price versus value-based price were calculated. A total of 239 economic articles focused on high-technology medical devices were selected from a standard PubMed search. Among these, the proportion of analyses unsuitable for value-based price estimation was high (191/239; 80%), whereas adequate clinical and economic information for estimating this parameter was available in 48 cases (20%). Standard equations of cost-effectiveness were applied. The value-based price was determined according to a willingness-to-pay threshold of 60,000 € per quality-adjusted life year. Real prices of devices were compared with the corresponding estimates of value-based prices. From each analysis, we extracted also the value of incremental cost-effectiveness ratio (ICER). Our final dataset included 47 analyses because one was published twice. There were five analyses in which the ICER could be estimated for the treatment, but not for the device. In the dataset of 42 analyses with complete information, 36 out of 42 devices (86%) were found to have an ICER lower than the pre-specified threshold (favorable ICER). Three ICERs were borderline. A separate analysis was conducted on the other three devices that showed an ICER substantially greater than the threshold (unfavorable ICER). Regarding value-based prices, the values of real price were appreciably lower than the corresponding value-based price in 36 cases (86%). For three devices, the real price was substantially higher than the value-based price. In the remaining three cases, real prices and value-based prices were very similar. To our knowledge, this is the first experience in which a systematic analysis of the literature has been focused on the application of value-based pricing in the field of high-technology devices. Our results are encouraging and suggest a wider application of cost-effectiveness in this field.

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“…In our previous article [ 12 ], we emphasized a few points, that are fully confirmed by the present investigation and that we repropose with nearly the same words:…”

Section: Reviewsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Estimation of Value-Based Price for 48 High-Technology Medical Devices

Hyeraci¹,

Trippoli²,

Rivano³

et al. 2023

Cureus

Self Cite

View full text Add to dashboard Cite

show abstract

“…Costs were varied across ranges reported in Table 2 : we assumed costs of hospital stay and drug costs would not vary, but assigned a standard deviation of 0.05 to the proportion of patients diagnosed in ICUs and considered the interquartile range of CAZ/AVI length of treatment for long course. For QALYs, we applied the ranges estimated by Koukoubani et al [ 22 ].…”

Section: Methodsmentioning

confidence: 99%

Cost-Effectiveness of Short Course of Ceftazidime/Avibactam for K. pneumoniae-KPC Bloodstream Infections in Italy

et al. 2023

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Background: Evidence has shown that short courses of antibiotic therapy are at least as effective as long courses with better clinical outcomes. CAZ/AVI has demonstrated its clinical efficacy in treating K. pneumoniae-KPC infections. Methods: We conducted an analysis based on the real-life data of our ten years retrospective cohort to assess the cost-effectiveness and cost-utility of a short course of CAZ/AVI plus source control compared to a long course plus source control. A Markov model was structured. Patient transition between health states was modeled, each transition has a probability, and each state has a cost and a utility. Incremental cost-effectiveness ratios (ICERs) were obtained by dividing the difference in costs by the difference in utilities between the two courses. Input parameter uncertainty was investigated through sensitivity analysis. We launched 1000 Monte Carlo simulations by iteratively perturbing variables within estimated variation ranges, obtaining an ICER result for each simulation. Results: In the first model (old appropriate treatment), a short course of treatment was associated with reduced costs per patient per year of €4818.60 and reduced effects (0.10 QALYs), compared to a long course. In the CAZ/AVI model, the short course was associated with increased costs of €1297.9 and with increased effects (0.04 QALYs), resulting in an ICER of €32,317.82 per QALY gained, below the WTP threshold of €40,000. Conclusions: Our findings highlight additional evidence regarding the cost-effectiveness of CAZ/AVI for policy-makers. We outline that CAZ/AVI could be cost-effective compared to old appropriate antibiotic therapies for KPC-Kp BSI.

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Estimation of Value-Based Price for Five High-Technology Medical Devices Approved by a Regional Health Technology Assessment Committee in Italy

Cited by 2 publications

References 21 publications

Estimation of Value-Based Price for 48 High-Technology Medical Devices

Estimation of Value-Based Price for 48 High-Technology Medical Devices

Cost-Effectiveness of Short Course of Ceftazidime/Avibactam for K. pneumoniae-KPC Bloodstream Infections in Italy

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