Measurement and valuation of the attributes of innovation of healthcare technologies: a systematic review

Figures & data

Table 1. Innovation attributes related to healthcare.

Attributes	Descriptions
Novelty	Novelty was the most stated attribute in describing innovation in healthcare. Novelty can address different healthcare demands, including first-in-class drug,^15–18 new approach to solve emerging and persistent health issue,^19^,^20 or something new/novel to fulfill the unmet^21–26. Broadly, any novel drug, products, services, and clinical practices that introduced over time into the provision of healthcare is a novelty^27^,^28.
Step change	Step change is a feature used to describe innovation. Technologies that produce lifesaving effects^29^,^30 or immediately convincing^31 were referred to as Step change. Instead of incremental improvement, technologies with breakthrough effect^32–34 that cure^35, prevent^35, or changes the course of disease states^36 were considered to offer a step change in terms of outcomes of patients^37.
Substantial benefit	As both novelty and step change attributes might potentially overlap with substantial benefit, so only those definitions that directly claimed a technology bringing significant, substantial, or considerable positive impact were considered under this attribute. The technology resulting in a substantial increase in overall survival,^38 substantial contributions to patient safety or quality,^39^,^40 large and positive impact on survival,^41 health and quality of life^42 were few examples found in works of literature that counted as substantial benefit attribute of innovation in this analysis.
Improvement over existing technologies	Exhibiting clinically relevant therapeutic advantages over the existing therapies was another attribute of innovative technologies^43. Compared to existing technologies, improvement in efficacy, effectiveness, safety, bioavailability, and existing products’ quality was referred to as improvement over existing technologies^20^,^44–48. Another aspect of this attribute was to reduce morbidity in the sick state, increase longevity and improve quality of life^49–51.
Convenience and/or adherence	Convenience, which is closely tied with adherence, are identified in several works of literature as innovation attributes. Optimal route,^19^,^52 decrease the dosage,^53 less frequent dosing (once daily or once weekly depending on conditions),^54^,^55 the capability of simplifying the multidrug administration along with maintaining appropriate drug release,^56 or improved palatability^57 were viewed as a convenience and/or adherence attribute of innovation. In the case of medical devices, portability was recognized as an essential feature of convenience that resulted in widespread acceptance^45^,^46.
Uncounted benefits	Innovative technology that produces a demonstrable and distinct benefit that may not have been adequately captured in the technology’s ICER calculation,^58 NICE demarcated these unnoticed and unrecognized benefits as uncounted benefits of innovation.
Acceptable cost	Several works of literature have recognized and hoped that the innovation in health care will offer better treatment, better patient care at a reduced cost or at least at the same cost compared to existing technologies^15^,^24^,^59–61. It was reported innovation at reduced cost would improve access to technologies^37^,^59.
Added value	Another feature of healthcare innovation is added value, which means innovative technology is expected to alleviate patient/social burden in the concerned disease^62. Value can be added to the system through several ways; increased productivity and knowledge spillovers (other due to innovation will produce indirect societal benefit^15 or innovative delivery system that allows a more decentralized health system to improve healthcare access and reduce health disparities are examples of added value^36^,^55^,^63.

Figure 1. PRISMA diagram of study selection process.

Figure 2. Identified measurement, valuation approaches, and recommended methods to capture healthcare innovation.

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