IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v109y2013i3p270-280.html
   My bibliography  Save this article

Regulatory space and the contextual mediation of common functional pressures: Analyzing the factors that led to the German Efficiency Frontier approach

Author

Listed:
  • Klingler, Corinna
  • Shah, Sara M.B.
  • Barron, Anthony J.G.
  • Wright, John S.F.

Abstract

There are no automatic links between the functional advantages and pressures associated with delegation to independent agencies for Health Technology Assessment (HTA) and their emergence in national regulatory spaces. We argue that the rise of these organizations is mediated by contextual factors, which must be explained. Accordingly, we analyze the German ‘regulatory space’ for health policy decision-making, identifying contextual factors relevant to the adoption of the Efficiency Frontier approach. Based on qualitative interviews with key stakeholders, we argue that the development of the Efficiency Frontier can be associated with cultural reluctance to frame healthcare prioritization decisions around cost based valuations of human health and related doubts about the validity of metrics for human health gain. Based on this finding, we conclude that the delegation of authority to independent HTA agencies follows a broadly evolutionary pattern, in which contextual factors allow for significant variation in institutional and methodological responses to the functional pressures and advantages leading to their establishment.

Suggested Citation

  • Klingler, Corinna & Shah, Sara M.B. & Barron, Anthony J.G. & Wright, John S.F., 2013. "Regulatory space and the contextual mediation of common functional pressures: Analyzing the factors that led to the German Efficiency Frontier approach," Health Policy, Elsevier, vol. 109(3), pages 270-280.
    • Handle: RePEc:eee:hepoli:v:109:y:2013:i:3:p:270-280
    DOI: 10.1016/j.healthpol.2013.01.004
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851013000146
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.healthpol.2013.01.004?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Michael F. Drummond;Frans Rutten, 2008. "New Guidelines for Economic Evaluation in Germany and the United Kingdom: Are We Any Closer to Developing International Standards?," Briefing 000237, Office of Health Economics.
    2. Young, Joni J., 1994. "Outlining regulatory space: Agenda issues and the FASB," Accounting, Organizations and Society, Elsevier, vol. 19(1), pages 83-109, January.
    3. Banta, H. David, 1994. "Health care technology as a policy issue," Health Policy, Elsevier, vol. 30(1-3), pages 1-21.
    4. Marmor, Theodore, 2012. "The unwritten rules of cross-national policy analysis," Health Economics, Policy and Law, Cambridge University Press, vol. 7(01), pages 19-20, January.
    5. Saltman, Richard B., 2012. "The role of comparative health studies for policy learning," Health Economics, Policy and Law, Cambridge University Press, vol. 7(01), pages 11-13, January.
    6. Michael Dickson & Jeremy Hurst & Stephane Jacobzone, 2003. "Survey of Pharmacoeconomic Assessment Activity in Eleven Countries," OECD Health Working Papers 4, OECD Publishing.
    7. J. Jaime Caro & Erik Nord & Uwe Siebert & Alistair McGuire & Maurice McGregor & David Henry & Gérard de Pouvourville & Vincenzo Atella & Peter Kolominsky‐Rabas, 2010. "The efficiency frontier approach to economic evaluation of health‐care interventions," Health Economics, John Wiley & Sons, Ltd., vol. 19(10), pages 1117-1127, October.
    8. Jonsson, Egon & Banta, H. David, 1994. "Health care technology in Sweden," Health Policy, Elsevier, vol. 30(1-3), pages 257-294.
    9. McCabe, C & Claxton, K & Culyer, AJ, 2008. "The NICE Cost-Effectiveness Threshold: What it is and What that Means," MPRA Paper 26466, University Library of Munich, Germany.
    10. Werner B. F. Brouwer & Frans F. H. Rutten, 2010. "The efficiency frontier approach to economic evaluation: will it help German policy making?," Health Economics, John Wiley & Sons, Ltd., vol. 19(10), pages 1128-1131, October.
    11. Tuohy, Carolyn H., 2012. "Shall we dance? The intricate project of comparison in the study of health policy," Health Economics, Policy and Law, Cambridge University Press, vol. 7(01), pages 21-23, January.
    12. Erik Nord & Jose Luis Pinto & Jeff Richardson & Paul Menzel & Peter Ubel, 1999. "Incorporating societal concerns for fairness in numerical valuations of health programmes," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 25-39, February.
    13. Sorenson, Corinna & Chalkidou, Kalipso, 2012. "Reflections on the evolution of health technology assessment in Europe," Health Economics, Policy and Law, Cambridge University Press, vol. 7(1), pages 25-45, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. repec:bla:glopol:v:8:y:2017:i::p:69-75 is not listed on IDEAS
    2. Barron, Anthony J.G. & Klinger, Corinna & Shah, Sara Mehmood Birchall & Wright, John S.F., 2015. "A regulatory governance perspective on health technology assessment (HTA) in France: The contextual mediation of common functional pressures," Health Policy, Elsevier, vol. 119(2), pages 137-146.
    3. Panos Kanavos & Olivier Wouters & John S. F. Wright & Anthony J. G. Barron & Sara M. B. Shah & Corinna Klingler, 2017. "Convergence, Divergence and Hybridity: A Regulatory Governance Perspective on Health Technology Assessment in England and Germany," Global Policy, London School of Economics and Political Science, vol. 8(s2), pages 69-75, March.
    4. Grepstad, Mari & Kanavos, Panos, 2015. "A comparative analysis of coverage decisions for outpatient pharmaceuticals: Evidence from Denmark, Norway and Sweden," Health Policy, Elsevier, vol. 119(2), pages 203-211.
    5. Sellars, Marcus & Carter, Stacy M. & Lancsar, Emily & Howard, Kirsten & Coast, Joanna, 2024. "Making recommendations to subsidize new health technologies in Australia: A qualitative study of decision-makers’ perspectives on committee processes," Health Policy, Elsevier, vol. 139(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. repec:bla:glopol:v:8:y:2017:i::p:69-75 is not listed on IDEAS
    2. Panos Kanavos & Olivier Wouters & John S. F. Wright & Anthony J. G. Barron & Sara M. B. Shah & Corinna Klingler, 2017. "Convergence, Divergence and Hybridity: A Regulatory Governance Perspective on Health Technology Assessment in England and Germany," Global Policy, London School of Economics and Political Science, vol. 8(s2), pages 69-75, March.
    3. Mark Sculpher & Karl Claxton, 2010. "Sins of omission and obfuscation: IQWIG's guidelines on economic evaluation methods," Health Economics, John Wiley & Sons, Ltd., vol. 19(10), pages 1132-1136, October.
    4. Poulsen, Peter Bo & Adamsen, Sven & Vondeling, Hindrik & Jorgensen, Torben, 1998. "Diffusion of laparoscopic technologies in Denmark," Health Policy, Elsevier, vol. 45(2), pages 149-167, August.
    5. Björn Stollenwerk & Stefan K. Lhachimi & Andrew Briggs & Elisabeth Fenwick & Jaime J. Caro & Uwe Siebert & Marion Danner & Andreas Gerber‐Grote, 2015. "Communicating the Parameter Uncertainty in the IQWiG Efficiency Frontier to Decision‐Makers," Health Economics, John Wiley & Sons, Ltd., vol. 24(4), pages 481-490, April.
    6. Werner B. F. Brouwer & Frans F. H. Rutten, 2010. "The efficiency frontier approach to economic evaluation: will it help German policy making?," Health Economics, John Wiley & Sons, Ltd., vol. 19(10), pages 1128-1131, October.
    7. Charalabos‐Markos Dintsios & Andreas Gerber, 2010. "Some essential clarifications: IQWiG comments on two critiques of the efficiency frontier approach," Health Economics, John Wiley & Sons, Ltd., vol. 19(10), pages 1139-1141, October.
    8. Erik Nord, 2011. "Discounting future health benefits: the poverty of consistency arguments," Health Economics, John Wiley & Sons, Ltd., vol. 20(1), pages 16-26, January.
    9. Afschin Gandjour, 2012. "Presenting Germany’s drug pricing rule as a cost-per-QALY rule," Health Care Management Science, Springer, vol. 15(2), pages 103-107, June.
    10. Christine McDonough & Anna Tosteson, 2007. "Measuring Preferences for Cost-Utility Analysis," PharmacoEconomics, Springer, vol. 25(2), pages 93-106, February.
    11. J. Jaime Caro & Erik Nord & Uwe Siebert & Alistair McGuire & Maurice McGregor & David Henry & Gérard de Pouvourville & Vincenzo Atella & Peter Kolominsky‐Rabas, 2010. "The efficiency frontier approach to economic evaluation of health‐care interventions," Health Economics, John Wiley & Sons, Ltd., vol. 19(10), pages 1117-1127, October.
    12. Saha, Sanjib & Gerdtham, Ulf-G. & Toresson, Håkan & Minthon, Lennart & Jarl, Johan, 2018. "Economic Evaluation of Interventions for Screening of Dementia," Working Papers 2018:20, Lund University, Department of Economics.
    13. Ryuichi Ohta & Yoshinori Ryu & Daisuke Kataoka & Chiaki Sano, 2021. "Effectiveness and Challenges in Local Self-Governance: Multifunctional Autonomy in Japan," IJERPH, MDPI, vol. 18(2), pages 1-14, January.
    14. Erik Nord, 2015. "Cost-Value Analysis of Health Interventions: Introduction and Update on Methods and Preference Data," PharmacoEconomics, Springer, vol. 33(2), pages 89-95, February.
    15. Michaël Schwarzinger & Jean‐Louis Lanoë & Erik Nord & Isabelle Durand‐Zaleski, 2004. "Lack of multiplicative transitivity in person trade‐off responses," Health Economics, John Wiley & Sons, Ltd., vol. 13(2), pages 171-181, February.
    16. Thomas Grochtdreis & Hans-Helmut König & Alexander Dobruschkin & Gunhild von Amsberg & Judith Dams, 2018. "Cost-effectiveness analyses and cost analyses in castration-resistant prostate cancer: A systematic review," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-25, December.
    17. Sanjib Saha & Ulf-G Gerdtham & Pia Johansson, 2010. "Economic Evaluation of Lifestyle Interventions for Preventing Diabetes and Cardiovascular Diseases," IJERPH, MDPI, vol. 7(8), pages 1-46, August.
    18. Saha, Sanjib & Gerdtham, Ulf-G. & Toresson, Håkan & Minthon, Lennart & Jarl, Johan, 2018. "Economic Evaluation of Nonpharmacological Interventions for Dementia Patients and their Caregivers - A Systematic Literature Review," Working Papers 2018:10, Lund University, Department of Economics.
    19. Anna Nicolet & Antoinette D I van Asselt & Karin M Vermeulen & Paul F M Krabbe, 2020. "Value judgment of new medical treatments: Societal and patient perspectives to inform priority setting in The Netherlands," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-18, July.
    20. repec:dau:papers:123456789/7515 is not listed on IDEAS
    21. Young, Joni J. & Williams, Paul F., 2010. "Sorting and comparing: Standard-setting and “ethical” categories," CRITICAL PERSPECTIVES ON ACCOUNTING, Elsevier, vol. 21(6), pages 509-521.
    22. Damschroder, Laura J. & Zikmund-Fisher, Brian J. & Ubel, Peter A., 2005. "The impact of considering adaptation in health state valuation," Social Science & Medicine, Elsevier, vol. 61(2), pages 267-277, July.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:109:y:2013:i:3:p:270-280. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.