https://orcid.org/0000-0002-1814-5852
![Sample our Medicine, Dentistry, Nursing & Allied Health journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5944/TOC-Subject-Sample-2021-Medicine-Dentistry-Nursing-Allied-Health.jpg"})
Abstract
Objective
Innovative technologies (e.g. treatments) play a pivotal role in improving patient’s well-being and in consequence population health outcomes. However, there is lack of consensus and comprehensive summary what constitutes innovation. Additionally, valuing them using traditional cost-effectiveness analysis is unlikely to capture the full range of benefits of these innovative technologies. This review aims to understand how innovation attributes were measured and/or valued in healthcare.
Materials and methods
We systemically searched four databases, PubMed, Embase, PsycINFO, and Econlit, from inception to April 2021. Studies were included if they measured and/or valued the attributes of innovation for healthcare identified in our previous systematic review. Any other potential recommended methods to measure and/or value the innovation attributes were also extracted.
Results
Of 546 articles, a total of 17 articles were finally included in this review. If attributes were measured and traded-off relative to costs, then it was considered as valuation of those attributes. Two specific attributes of innovation, i.e. substantial benefits and convenience and/or adherence were measured using adherence rate and life year or QALY gain. When innovation attribute was non-specific it was described as “overall innovation” and measured using overall innovativeness scale (e.g. point/binary scale). QALY-based cost-effectiveness analysis (CEA) was commonly used to assess and value substantial benefit attribute. Other valuation approaches were (i) rating, (ii) the economic value of life year gain, (iii) multiple criteria decision analysis (MCDA), (iv) incremental net health benefit (INHB), and (v) quality-adjusted cost of care (QACC). ICER threshold adjustment and multiple-criteria decision analysis (MCDA) are two common recommended approaches to capture the innovation comprehensively. We found that MCDA approaches often promoted and discussed but were sub-optimally used to incorporate different value attributes into decision-making.
Conclusions
Existing methods used by payers to measure and value the innovation component of a new product do not reflect the full range of health and cost impacts. They generally do not consider the alternative perspectives of patients, providers, caregivers, and society. Key challenges remain to appropriately measure and value innovation attributes and incorporate them into HTA decision making.
Transparency
Declaration of funding
This work was supported by Bristol Myers Squibb (BMS). BMS also provided funding for the development of the manuscript as well as for article processing charges.
Declaration of financial/other relationships
JD is employed by Bristol Myers Squibb. All other authors have indicated that they have no conflicts of interest regarding the content of this article.
Author contributions
SS and NP reviewed literatures, extracted data for the study, synthesis, and conceptualization with input from NC, SN, and JD. SS, NP, SN, JD, and SS wrote the first drafts of the manuscript and all authors made substantial contribution. All authors contributed to the study design, interpretation of findings, and critical revision of the manuscript.
Acknowledgement
We are grateful to Sajesh K. Veettil for assistance in study selection process.
Reviewer disclosures
A reviewer on this manuscript has disclosed that they are friends with three of the senior authors on the paper. The rest of the peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.
Availability of data and material
All data are available from the corresponding author upon request.
Consent for publication
All authors approved the final version of the manuscript for submission.