Costing and Cost Effectiveness
Internationally, payors rely on cost-effectiveness analyses in making their coverage decisions, and in the U.S there is a growing movement among payers to adopt these approaches to evaluate both the health and economic impact of medical devices. Our group has a particular interest in understanding the cost and cost-effectiveness of surgically implantable devices.
To a greater degree than other medical therapies, surgically implantable devices are characterized by a high degree of innovation and “learning by using.” As a result, traditional methods of evaluation suffer from inherent limitations. Specifically, while innovation is dynamic and medical technologies change over time, evidence is static with findings from a fixed time period.
The dynamic nature of surgically implantable devices and their application complicates the ability of policy makers to obtain rigorous and timely evidence to guide decisions on adoption and use of new technologies. In order to overcome these limitations, we make extensive use of advanced analytical techniques to account for potential changes in the technology, operator experience, patient management, and target populations over the study period. These include patient risk stratification, volume-outcome analysis, learning analysis, assessment of temporal trends, sensitivity analysis, Markov modeling, and incorporation of data collected beyond the close of the study period.