Use of innovation payments to encourage the adoption of new medical technologies in the English NHS

Sorenson, Corinna; Drummond, Michael; Wilkinson, G.

doi:10.1016/j.hlpt.2013.05.001

Cited by 12 publications

(10 citation statements)

References 17 publications

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“…The starting point of an early benefit assessment is the hospitals' first application on innovation payments for new technologies, so-called New Diagnostic and Treatment Methods. Innovation payments are separate from the system of diagnosisrelated groups (DRGs) in that they involve additional funding (i.e., are paid on a fee-for-service basis) and are negotiated locally [27,28]. The benefit assessment of a method leads to one of the following results: (1) sufficient proof of benefit, (2) no sufficient proof but potential of benefit, or (3) no sufficient proof of benefit.…”

Section: Brief Overview Of 2016 German Ced Reformmentioning

confidence: 99%

Physicians’ Decision Making on Adoption of New Technologies and Role of Coverage with Evidence Development: A Qualitative Study

Felgner

Henschke

2018

Value in Health

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Section: Brief Overview Of 2016 German Ced Reformmentioning

confidence: 99%

Physicians’ Decision Making on Adoption of New Technologies and Role of Coverage with Evidence Development: A Qualitative Study

Felgner

Henschke

2018

Value in Health

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“…This system was established in 2005 and involves socalled 'NUB payments,' named after the German acronym for 'New Section 6(2) KHEntgG, Hospital Payment Act). From an international perspective, NUB payments can be classified as payments that are separate from the DRG system, involve additional funding (i.e., are paid on fee-for-service basis) and are negotiated locally (Sorenson, Drummond, and Wilkinson 2013;Scheller-Kreinsen, Quentin, and Busse 2011). We will refer to NUB payments as 'innovation payments' due to internationally different terms.…”

Section: Background: Innovation Payments In Germanymentioning

confidence: 99%

“…From an international perspective, NUB payments can be classified as payments that are separate from the DRG system, involve additional funding (i.e. are paid on fee-for-service basis) and are negotiated locally (Scheller-Kreinsen et al ., 2011; Sorenson et al ., 2013). We will refer to NUB payments as ‘innovation payments’ due to internationally different terms.…”

Section: Background: Innovation Payments In Germanymentioning

confidence: 99%

“…With the aim to balance these financial disincentives for technologies that are currently not covered by health insurances – due to the time lack when introducing technologies in DRG systems – policy stakeholders use additional payment instruments to finance certain innovative technologies cost-neutrally. Studies investigating the utilisation of innovation payments in individual countries showed that these payments are overall correlated with adopting innovations (Bech et al ., 2009; Bäumler, 2013; Sorenson et al ., 2013; Wilkinson and Drummond, 2014). To explore the effect of innovation payments, most of these studies investigate the uptake of one specific technology by the respective hospital departments in a certain region.…”

Section: Introductionmentioning

confidence: 99%

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The reimbursement of new medical technologies in German inpatient care: What factors explain which hospitals receive innovation payments?

Vogt

Busse

et al. 2019

HEPL

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Most hospital payment systems based on diagnosis-related groups (DRGs) provide payments for newly approved technologies. In Germany, they are negotiated between individual hospitals and health insurances. The aim of our study is to assess the functioning of temporary reimbursement mechanisms. We used multilevel logistic regression to examine factors at the hospital and state levels that are associated with agreeing innovation payments. Dependent variable was whether or not a hospital had successfully negotiated innovation payments in 2013 (n = 1532). Using agreement data of the yearly budget negotiations between each German hospital and representatives of the health insurances, the study comprises all German acute hospitals and innovation payments on all diagnoses. In total, 32.9% of the hospitals successfully negotiated innovation payments in 2013. We found that the chance of receiving innovation payments increased if the hospital was located in areas with a high degree of competition and if they were large, had university status and were private for-profit entities. Our study shows an implicit self-controlled selection of hospitals receiving innovation payments. While implicitly encouraging safety of patient care, policy makers should favour a more direct and transparent process of distributing innovation payments in prospective payment systems.

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“…(1), which includes a broad range of different products for purposes such as prevention, diagnosis, monitoring, treatment, alleviation of disease, or compensation for an injury or handicap (1). Many of these devices have led to important improvements in diagnosis and treatment of diseases such as better health outcomes in terms of higher life expectancy and/or better quality of life (2)(3)(4). However, their rapid pace of innovation might also be associated with risks (5) and cause harm to patients.…”

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confidence: 99%

Taxonomy of Medical Devices in the Logic of Health Technology Assessment

Henschke¹,

Panteli

Perleth

et al. 2015

Int J Technol Assess Health Care

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Objectives: The suitability of general HTA methodology for medical devices is gaining interest as a topic of scientific discourse. Given the broad range of medical devices, there might be differences between groups of devices that impact both the necessity and the methods of their assessment. Our aim is to develop a taxonomy that provides researchers and policy makers with an orientation tool on how to approach the assessment of different types of medical devices. Methods: Several classifications for medical devices based on varying rationales for different regulatory and reporting purposes were analyzed in detail to develop a comprehensive taxonomic model. Results: The taxonomy is based on relevant aspects of existing classification schemes incorporating elements of risk and functionality. Its 9 × 6 matrix distinguishes between the diagnostic or therapeutic nature of devices and considers whether the medical device is directly used by patients, constitutes part of a specific procedure, or can be used for a variety of procedures. We considered the relevance of different device categories in regard to HTA to be considerably variable, ranging from high to low. Conclusions: Existing medical device classifications cannot be used for HTA as they are based on different underlying logics. The developed taxonomy combines different device classification schemes used for different purposes. It aims at providing decision makers with a tool enabling them to consider device characteristics in detail across more than one dimension. The placement of device groups in the matrix can provide decision support on the necessity of conducting a full HTA. Keywords: Health technology assessment, Medical devices, ClassificationHealth technologies such as medical devices are an essential part of health care. The European Union defines a medical device as " [ . . . ] any instrument, apparatus, appliance, software, material or other article, whether used alone or in combination, together with any accessories [ . . . ]" (1), which includes a broad range of different products for purposes such as prevention, diagnosis, monitoring, treatment, alleviation of disease, or compensation for an injury or handicap (1). Many of these devices have led to important improvements in diagnosis and treatment of diseases such as better health outcomes in terms of higher life expectancy and/or better quality of life (2-4). However, their rapid pace of innovation might also be associated with risks (5) and cause harm to patients. Recent examples arising from the use of medical devices include recalls of specific types of breast implants (6), artificial hips (7), and implantable cardioverter-defibrillators (8). Furthermore, fast-paced innovation is accompanied by rising health expenditures (9;10). The combined imperatives of patient benefit and safety as well as cost containment have led many countries to introduce regulatory instruments to identify technologies that minimize risk and ensure value and value for money.There are two approaches to regulate medic...

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Use of innovation payments to encourage the adoption of new medical technologies in the English NHS

Cited by 12 publications

References 17 publications

Physicians’ Decision Making on Adoption of New Technologies and Role of Coverage with Evidence Development: A Qualitative Study

Physicians’ Decision Making on Adoption of New Technologies and Role of Coverage with Evidence Development: A Qualitative Study

The reimbursement of new medical technologies in German inpatient care: What factors explain which hospitals receive innovation payments?

Taxonomy of Medical Devices in the Logic of Health Technology Assessment

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