Medical technology as a key driver of rising health expenditure: disentangling the relationship

Abstract

Health care spending has risen steadily in most countries, becoming a concern for decision-makers worldwide. Commentators often point to new medical technology as the key driver for burgeoning expenditures. This paper critically appraises this conjecture, based on an analysis of the existing literature, with the aim of offering a more detailed and considered analysis of this relationship. Several databases were searched to identify relevant literature. Various categories of studies (eg, multivariate and cost-effectiveness analyses) were included to cover different perspectives, methodological approaches, and issues regarding the link between medical technology and costs. Selected articles were reviewed and relevant information was extracted into a standardized template and analyzed for key cross-cutting themes, ie, impact of technology on costs, factors influencing this relationship, and methodological challenges in measuring such linkages. A total of 86 studies were reviewed. The analysis suggests that the relationship between medical technology and spending is complex and often conflicting. Findings were frequently contingent on varying factors, such as the availability of other interventions, patient population, and the methodological approach employed. Moreover, the impact of technology on costs differed across technologies, in that some (eg, cancer drugs, invasive medical devices) had significant financial implications, while others were cost-neutral or cost-saving. In light of these issues, we argue that decision-makers and other commentators should extend their focus beyond costs solely to include consideration of whether medical technology results in better value in health care and broader socioeconomic benefits.

Method for selecting expert groups and determining the importance of experts' judgments for the purpose of managerial decision-making tasks in health system 

“…When an expert's evaluation is close to the group's evaluation, the competence of this expert is treated as higher [21] and this fact could be used as a way of experts' competence determining. It should be noted, that grope opinion of experts with close overall competence level would have higher conformity [27].…”

“…Current trends in scientifi c and technological advances are bringing a signifi cant improvements in health care as a result of creation new tools tool to support decision making process for decision-makers (DM) [8], [11], [12], [23], [27]. The experts group approach is used in health sector both clinical [28], [31] and nonclinical [5], [24], [29], [30], [32] decision-making.…”

Private hospital expenditure and relation to utilisation: Observations from the data

“…The relevant international literature provides a significant amount of discussion and empirical work on the portion of healthcare cost and expenditure increases that is driven by new technology. There are also numerous international literature reviews available on this topic (see, e.g., Sorensen, Drummond & Kahn 2013).…”

Avaliação da capacidade de gestão do componente especializado da assistência farmacêutica

“…Health technologies, which include medicines, are one of the factors in the increase in spending on health in most countries 1 . This growth can be attributed to the change in epidemiological profiles, the pressure for incorporation of new technologies in public services, and expansion of access to health systems 2 .…”