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How to design the cost‐effectiveness appraisal process of new healthcare technologies to maximise population health: A conceptual framework

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  • Kasper M. Johannesen
  • Karl Claxton
  • Mark J. Sculpher
  • Allan J. Wailoo

Abstract

This paper presents a conceptual framework to analyse the design of the cost‐effectiveness appraisal process of new healthcare technologies. The framework characterises the appraisal processes as a diagnostic test aimed at identifying cost‐effective (true positive) and non‐cost‐effective (true negative) technologies. Using the framework, factors that influence the value of operating an appraisal process, in terms of net gain to population health, are identified. The framework is used to gain insight into current policy questions including (a) how rigorous the process should be, (b) who should have the burden of proof, and (c) how optimal design changes when allowing for appeals, price reductions, resubmissions, and re‐evaluations. The paper demonstrates that there is no one optimal appraisal process and the process should be adapted over time and to the specific technology under assessment. Optimal design depends on country‐specific features of (future) technologies, for example, effect, price, and size of the patient population, which might explain the difference in appraisal processes across countries. It is shown that burden of proof should be placed on the producers and that the impact of price reductions and patient access schemes on the producer's price setting should be considered when designing the appraisal process.

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  • Kasper M. Johannesen & Karl Claxton & Mark J. Sculpher & Allan J. Wailoo, 2018. "How to design the cost‐effectiveness appraisal process of new healthcare technologies to maximise population health: A conceptual framework," Health Economics, John Wiley & Sons, Ltd., vol. 27(2), pages 41-54, February.
  • Handle: RePEc:wly:hlthec:v:27:y:2018:i:2:p:e41-e54
    DOI: 10.1002/hec.3561
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    References listed on IDEAS

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    1. Kasper Johannesen & Magnus Janzon & Tomas Jernberg & Martin Henriksson, 2020. "Subcategorizing the Expected Value of Perfect Implementation to Identify When and Where to Invest in Implementation Initiatives," Medical Decision Making, , vol. 40(3), pages 327-338, April.

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