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Why Do Health Economists Promote Technology Adoption Rather Than the Search for Efficiency? A Proposal for a Change in Our Approach to Economic Evaluation in Health Care

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  • Graham Scotland
  • Stirling Bryan

Abstract

At a time of intense pressure on health care budgets, the technology management challenge is for disinvestment in low-value technologies and reinvestment in higher value alternatives. The aim of this article is to explore ways in which health economists might begin to redress the observed imbalance between the evaluation of new and existing in-use technologies. The argument is not against evaluating new technologies but in favor of the “search for efficiency,†where the ultimate objective is to identify reallocations that improve population health in the face of resource scarcity. We explore why in-use technologies may be of low value and consider how economic evaluation analysts might embrace a broader efficiency lens, first through “technology management†(a process of analysis and evidence-informed decision making throughout a technology’s life cycle) and progressing through “pathway management†(the search for efficiency gains across entire clinical care pathways). A number of model-based examples are used to illustrate the approaches.

Suggested Citation

  • Graham Scotland & Stirling Bryan, 2017. "Why Do Health Economists Promote Technology Adoption Rather Than the Search for Efficiency? A Proposal for a Change in Our Approach to Economic Evaluation in Health Care," Medical Decision Making, , vol. 37(2), pages 139-147, February.
    • Handle: RePEc:sae:medema:v:37:y:2017:i:2:p:139-147
    DOI: 10.1177/0272989X16653397
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    References listed on IDEAS

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    1. Christopher J.L. Murray & David B. Evans & Arnab Acharya & Rob M.P.M. Baltussen, 2000. "Development of WHO guidelines on generalized cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 9(3), pages 235-251, April.
    2. Sander Greenland, 2005. "Multiple‐bias modelling for analysis of observational data," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 168(2), pages 267-306, March.
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    Cited by:

    1. Hofmann, Bjørn, 2020. "Biases distorting priority setting," Health Policy, Elsevier, vol. 124(1), pages 52-60.
    2. MacNeil, Maggie & Koch, Melissa & Kuspinar, Ayse & Juzwishin, Don & Lehoux, Pascale & Stolee, Paul, 2019. "Enabling health technology innovation in Canada: Barriers and facilitators in policy and regulatory processes," Health Policy, Elsevier, vol. 123(2), pages 203-214.

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