DISTINCTIVE MEDICAL DEVICE FEATURES AND THEIR IMPLICATIONS FOR HEALTH POLICY: INNOVATION, SAFETY, EFFICIENCY, EQUITY, AND DATA NEEDS
Topic 1: Current state of the market for medical devices
This session will discuss the distinct characteristics of medical devices as an economic good, and the factors that affect their effective and efficient use. The session will analyze the key features of current regulatory and reimbursement environments in Europe and the USA affecting remuneration for innovation in the medical device industry, and their consequences for access to services and patient health benefits. It will also address the contribution of medical devices to recent trends in healthcare expenditures in the USA and the UK, focusing on spending for older adults, and the increasing quality of longer lifespans. The discussion will conclude with ideas about healthcare policymakers’ challenge of balancing the need to minimise health risks and contain costs while also fostering innovation in medical devices.
Topic 2: What policy instruments are conducive to meeting the needs of an aging population for medical devices and what evidence is required to inform reimbursement decisions?
In this part of the session, discussants will assess the US and European movements toward making reimbursement decisions based on assessments of economic value, and their likely short- and long-term implications for access to medical devices—especially given the prospect of increasingly restricted budgets and aging populations. Attention will be given to the effects that policies outside the healthcare context may have on the demand for and ability to benefit from medical devices, in the light of emerging evidence from the Dartmouth Atlas and the Public Health Atlas surrounding variations in access to and the use of medical devices. The session will also address the potential implications that developments such as coverage with evidence and value-based pricing are likely to have on the research agenda, its methods, and data needed to inform resource allocation decisions.
Topic 3: What have we learned to date from economics research on medical devices?
The final part will be devoted to discussing the way economics has informed key policy decisions, through evidence from studies of patient and doctor attitudes to risk and ambiguity of medical device use, optimal contract designs in medical device procurement and regulation, effects of competition by product differentiation, and incentives embodied in reimbursement policies such as payment by results or quality of health outcomes. This will also include an analysis of the fundamental question of identifying counterfactual outcomes of medical devices, and the robustness of non-randomized approaches that have been used in evaluation. Finally, discussants will propose a relevant economist’s research agenda for the future, identifying current barriers to its pursuit and their possible solutions.
The session will conclude with a summary of main points from each topic.