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"

Abstract

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.

The Use of Decision Analytic Modeling in the Evaluation of Surgical Innovations: A Scoping Review

“…66 Decisions regarding the reimbursement of medical devices often do not require a formal assessment after obtaining CE or FDA approval. 1,[67][68][69] This also applies to innovative surgical procedures. Moreover, these procedures are often initiated by individual practitioners and arise spontaneously.…”

Exploratory, Participatory and Iterative Assessment of Value: A Response to Recent Commentaries

“…Several authors provide valuable suggestions for dealing with the lack of evidence in the early stages of development of a medical technology, such as clinical trial simulation and expert elicitation. 2,6 Most of these focus on quantifying the known unknowns, with a focus on prediction. While in these cases PSA and value of information are technically possible, we argue that in such early stages exploration may be more valuable than prediction.…”

“…e were deeply honoured that so many reputable scholars read our article and took the effort to write no less than eight thoughtful and interesting commentaries. [1][2][3][4][5][6][7][8] Writing the original paper was sometimes a struggle, because it was an unconventional paper. However, we felt a strong urge to make these assessments -that are often confidential and not publicly available -public, and share our experiences to advance this important and timely field of research.…”

“…Radboud University Medical Center, Nijmegen, The Netherlands. 2 Department for Operating Rooms, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands. 3 Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.…”

Taking comfort in decisions: Implications in a pandemic

“…The second macro area involves modelling Management Practices, which includes decision models used in government level programs such as the Medicaid system in the United States [15] or home health services [16]; large health systems such as managing conglomerates of hospitals formed in health care mergers and resource allocation between hospitals [17][18][19]; sundry management issues arising in hospitals, and day-to-day decision modeling at a micro level such as scheduling personnel [20,21], managing intensive care units [22,23] disaster preparedness [24] and allocating resources in the Covid-19 pandemic [25,26]. At the intersection of these two categories is the issue of modeling technologies which can be medically oriented or management oriented [27] and decision modeling methodologies.…”