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Balancing adoption and affordability of medical devices in Europe

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  • Schreyögg, Jonas
  • Bäumler, Michael
  • Busse, Reinhard

Abstract

Dramatic increases in health expenditures have led to a substantial number of regulatory interventions in the markets for devices over the last years. However, little attention has been paid thus far to the regulation of medical devices and its effects. This article explores the policies pursued by European countries to find the right balance between improving access to new medical devices and restricting market forces to contain costs and ensure affordability. We outline the medical device policies of the four European countries with the largest expenditures on devices: Germany, France, Italy, and the UK. Subsequently, we discuss how these policies attempt to balance technological adoption and affordability by illustrating two case studies from Italy and Germany. We find that reference prices, if defined as maximum reimbursement levels, can help to achieve balance, because they are supposed to contain costs effectively, but do not necessarily act as a hurdle for the adoption of innovations. We also find that policy tools that encourage technological adoption should be used carefully since the benefits of a new technology are often difficult to predict. Finally, we draw a number of policy implications based on our observations.

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Bibliographic Info

Article provided by Elsevier in its journal Health Policy.

Volume (Year): 92 (2009)
Issue (Month): 2-3 (October)
Pages: 218-224

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Handle: RePEc:eee:hepoli:v:92:y:2009:i:2-3:p:218-224

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Web page: http://www.elsevier.com/locate/healthpol

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Keywords: Medical devices Resource allocation Financing Regulation Europe;

References

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  1. Cookson, Richard & Hutton, John, 2003. "Regulating the economic evaluation of pharmaceuticals and medical devices: a European perspective," Health Policy, Elsevier, vol. 63(2), pages 167-178, February.
  2. Jonas Schreyögg & Tom Stargardt & Oliver Tiemann & Reinhard Busse, 2006. "Methods to determine reimbursement rates for diagnosis related groups (DRG): A comparison of nine European countries," Health Care Management Science, Springer, vol. 9(3), pages 215-223, August.
  3. David M. Cutler, 2007. "The Lifetime Costs and Benefits of Medical Technology," NBER Working Papers 13478, National Bureau of Economic Research, Inc.
  4. Rosanna Tarricone & Monia Marchetti & Mark Lamotte & Lieven Annemans & Peter Jong, 2004. "What reimbursement for coronary revascularization with drug-eluting stents?," The European Journal of Health Economics, Springer, vol. 5(4), pages 309-316, November.
  5. Andreas Werblow & Stefan Felder & Peter Zweifel, 2007. "Population ageing and health care expenditure: a school of 'red herrings'?," Health Economics, John Wiley & Sons, Ltd., vol. 16(10), pages 1109-1126.
  6. Simoens, Steven & De Coster, Sandra & Moldenaers, Ingrid & Guillaume, Paul & Depoorter, Antony & Van den Steen, Dirk & Van de Sande, Stefaan & Debruyne, Hans & Ramaekers, Dirk & Lona, Murielle, 2008. "Reforming the Belgian market for orthotic braces: What can we learn from the international experience?," Health Policy, Elsevier, vol. 86(2-3), pages 195-203, May.
  7. Aleksandra Torbica & Giovanni Fattore, 2005. "The “Essential Levels of Care” in Italy: when being explicit serves the devolution of powers," The European Journal of Health Economics, Springer, vol. 6(1), pages 46-52, November.
  8. Cutler, David, 2007. "The Lifetime Costs and Benefits of Medical Technology," Scholarly Articles 2643640, Harvard University Department of Economics.
  9. Di Matteo, Livio, 2005. "The macro determinants of health expenditure in the United States and Canada: assessing the impact of income, age distribution and time," Health Policy, Elsevier, vol. 71(1), pages 23-42, January.
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Citations

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Cited by:
  1. Gallego, Gisselle & Casey, Robert & Norman, Richard & Goodall, Stephen, 2011. "Introduction and uptake of new medical technologies in the Australian health care system: A qualitative study," Health Policy, Elsevier, vol. 102(2), pages 152-158.
  2. Rosella Levaggi & Michele Moretto & Paolo Pertile, 2012. "DRGs: the link between investment in technologies and appropriateness," Working Papers 31/2012, University of Verona, Department of Economics.
  3. Fischer, Katharina E. & Rogowski, Wolf H. & Leidl, Reiner & Stollenwerk, Björn, 2013. "Transparency vs. closed-door policy: Do process characteristics have an impact on the outcomes of coverage decisions? A statistical analysis," Health Policy, Elsevier, vol. 112(3), pages 187-196.
  4. Levaggi, Rosella & Moretto, Michele & Pertile, Paolo, 2014. "Two-part payments for the reimbursement of investments in health technologies," Health Policy, Elsevier, vol. 115(2), pages 230-236.
  5. Henschke, Cornelia, 2012. "Provision and financing of assistive technology devices in Germany: A bureaucratic odyssey? The case of amyotrophic lateral sclerosis and Duchenne muscular dystrophy," Health Policy, Elsevier, vol. 105(2), pages 176-184.
  6. Sorenson, Corinna & Kanavos, Panos, 2011. "Medical technology procurement in Europe: A cross-country comparison of current practice and policy," Health Policy, Elsevier, vol. 100(1), pages 43-50, April.

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