IDEAS home Printed from https://ideas.repec.org/a/spr/aphecp/v19y2021i2d10.1007_s40258-020-00610-8.html
   My bibliography  Save this article

Impact of Guidelines on the Diffusion of Medical Technology: A Case Study of Cardiac Resynchronization Therapy in the UK

Author

Listed:
  • Rucha Vadia

    (University of Hamburg
    Abbott, Health Economics & Reimbursement)

  • Tom Stargardt

    (University of Hamburg)

Abstract

Introduction Research on clinical practice guidelines as a determinant of the diffusion of medical technology remains sparse. We aim to evaluate the impact of guidelines on the awareness of medical technology, as a proxy of its use, with the example of cardiac resynchronization therapy (CRT) in the United Kingdom (UK). Methods We measured clinician awareness based on Google searches performed for CRT that corresponded with actual CRT implant numbers provided by the European Heart Rhythm Association (EHRA). We identified the guideline recommendations published by the National Institute of Health and Care Excellence (NICE) within the UK, the European Society of Cardiology (ESC) at the European level, and the American College of Cardiology Foundation/American Heart Association in the United States (US). We specified a dynamic moving average model, with Google searches as the dependent variable and guideline changes as the independent variables. Results One guideline change published by NICE in 2007 and two changes released by the US guidelines in 2005 and 2012 were significantly correlated with the Google searches (p = 0.08, p = 0.02, and p = 0.02, respectively). Guideline changes by the ESC had no significant impact. Changes recommending CRT in place of a conventional pacemaker, in patients with atrial fibrillation, and restricting CRT due to contraindication, remained universally uninfluential. Conclusion The factors associated with a lack of awareness (as a proxy for technology diffusion) in our case study were: a lack of strong clinical evidence that resulted in the moderate strength of a recommendation, a lack of recognition of any externally published recommendation by NICE, and the frequent release of guidelines with minor changes targeting small patient groups. At least in our case, in the absence of NICE guidelines, the US guidelines received more attention than their non-UK European counterparts, even if the former were released after the latter.

Suggested Citation

  • Rucha Vadia & Tom Stargardt, 2021. "Impact of Guidelines on the Diffusion of Medical Technology: A Case Study of Cardiac Resynchronization Therapy in the UK," Applied Health Economics and Health Policy, Springer, vol. 19(2), pages 243-252, March.
    • Handle: RePEc:spr:aphecp:v:19:y:2021:i:2:d:10.1007_s40258-020-00610-8
    DOI: 10.1007/s40258-020-00610-8
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s40258-020-00610-8
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.
    File URL: https://libkey.io/10.1007/s40258-020-00610-8?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. Varabyova, Yauheniya & Blankart, Carl Rudolf & Greer, Ann Lennarson & Schreyögg, Jonas, 2017. "The determinants of medical technology adoption in different decisional systems: A systematic literature review," Health Policy, Elsevier, vol. 121(3), pages 230-242.
    2. Michael Dickson & Stephane Jacobzone, 2003. "Pharmaceutical Use and Expenditure for Cardiovascular Disease and Stroke: A Study of 12 OECD Countries," OECD Health Working Papers 1, OECD Publishing.
    3. Greenberg, Dan & Peiser, Jochanan G. & Peterburg, Yitzhak & Pliskin, Joseph S., 2001. "Reimbursement policies, incentives and disincentives to perform laparoscopic surgery in Israel," Health Policy, Elsevier, vol. 56(1), pages 49-63, April.
    4. Slade, Eric P. & Anderson, Gerard F., 2001. "The relationship between per capita income and diffusion of medical technologies," Health Policy, Elsevier, vol. 58(1), pages 1-14, October.
    5. Rosanna Tarricone & Aleksandra Torbica & Michael Drummond & for the MedtecHTA Project Group, 2017. "Key Recommendations from the MedtecHTA Project," Health Economics, John Wiley & Sons, Ltd., vol. 26(S1), pages 145-152, February.
    6. Rosanna Tarricone & Aleksandra Torbica & Michael Drummond, 2017. "Key Recommendations from the MedtecHTA Project," Health Economics, John Wiley & Sons, Ltd., vol. 26, pages 145-152, February.
    7. Dirksen, Carmen D. & Ament, AndreJ. H. & Go, Peter M. N., 1996. "Diffusion of six surgical endoscopic procedures in the Netherlands. Stimulating and restraining factors," Health Policy, Elsevier, vol. 37(2), pages 91-104, August.
    Full references (including those not matched with items on IDEAS)

    Citations

    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Journal round-up: Applied Health Economics and Health Policy 19(2)
      by karanshahk2 in The Academic Health Economists' Blog on 2021-04-19 06:00:07

    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. Bech, Mickael & Christiansen, Terkel & Dunham, Kelly & Lauridsen, Jørgen & Lyttkens, Carl Hampus & McDonald, Kathryn & McGuire, Alistair & TECH investigators, the, 2006. "How do economic incentives and regulatory factors influence adoption of cardiac technologies? Result from the TECH project," Working Papers 2006:15, Lund University, Department of Economics.
    2. Mickael Bech & Terkel Christiansen & Kelly Dunham & Jørgen Lauridsen & Carl Hampus Lyttkens & Kathryn McDonald & Alistair McGuire & and the TECH Investigators, 2009. "The influence of economic incentives and regulatory factors on the adoption of treatment technologies: a case study of technologies used to treat heart attacks," Health Economics, John Wiley & Sons, Ltd., vol. 18(10), pages 1114-1132, October.
    3. Martina F. Baumann & Daniel Frank & Lena-Charlotte Kulla & Thomas Stieglitz, 2020. "Obstacles to Prosthetic Care—Legal and Ethical Aspects of Access to Upper and Lower Limb Prosthetics in Germany and the Improvement of Prosthetic Care from a Social Perspective," Societies, MDPI, vol. 10(1), pages 1-20, January.
    4. Sarri, Grammati & Freitag, Andreas & Szegvari, Boglarka & Mountian, Irina & Brixner, Diana & Bertelsen, Neil & Kaló, Zoltán & Upadhyaya, Sheela, 2021. "The Role of Patient Experience in the Value Assessment of Complex Technologies – Do HTA Bodies Need to Reconsider How Value is Assessed?," Health Policy, Elsevier, vol. 125(5), pages 593-601.
    5. Rosanna Tarricone & Giuditta Callea & Marko Ogorevc & Valentina Prevolnik Rupel, 2017. "Improving the Methods for the Economic Evaluation of Medical Devices," Health Economics, John Wiley & Sons, Ltd., vol. 26(S1), pages 70-92, February.
    6. Rosanna Tarricone & Aleksandra Torbica & Michael Drummond, 2017. "Challenges in the Assessment of Medical Devices: The MedtecHTA Project," Health Economics, John Wiley & Sons, Ltd., vol. 26(S1), pages 5-12, February.
    7. Rituparna Basu & Simon Eggington & Natalie Hallas & Liesl Strachan, 2024. "Are Medical Device Characteristics Included in HTA Methods Guidelines and Reports? A Brief Review," Applied Health Economics and Health Policy, Springer, vol. 22(5), pages 653-664, September.
    8. Meilin Möllenkamp & Benedetta Pongiglione & Stefan Rabbe & Aleksandra Torbica & Jonas Schreyögg, 2022. "Spillover effects and other determinants of medical device uptake in the presence of a medical guideline: An analysis of drug‐eluting stents in Germany and Italy," Health Economics, John Wiley & Sons, Ltd., vol. 31(S1), pages 157-178, September.
    9. Sara Ghaboulian Zare & Reza Hafezi & Mohammad Alipour & Reza Parsaei Tabar & Rodney A. Stewart, 2021. "Residential Solar Water Heater Adoption Behaviour: A Review of Economic and Technical Predictors and Their Correlation with the Adoption Decision," Energies, MDPI, vol. 14(20), pages 1-26, October.
    10. Ludwig, Jens & Marcotte, Dave E. & Norberg, Karen, 2009. "Anti-depressants and suicide," Journal of Health Economics, Elsevier, vol. 28(3), pages 659-676, May.
    11. Michael Drummond & Rosanna Tarricone & Aleksandra Torbica, 2016. "Incentivizing research into the effectiveness of medical devices," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(9), pages 1055-1058, December.
    12. Karine Lamiraud & Stephane Lhuillery, 2016. "Endogenous Technology Adoption and Medical Costs," Health Economics, John Wiley & Sons, Ltd., vol. 25(9), pages 1123-1147, September.
    13. Lambrelli D & O’Donnell O, 2009. "Why Does the Utilization of Pharmaceuticals Vary So Much Across Europe? Evidence from Micro Data on Older Europeans," Health, Econometrics and Data Group (HEDG) Working Papers 09/06, HEDG, c/o Department of Economics, University of York.
    14. Aysegul Timur & Gabriel Picone & Jeffrey DeSimone, 2011. "Has the European union achieved a single pharmaceutical market?," International Journal of Health Economics and Management, Springer, vol. 11(4), pages 223-244, December.
    15. Barrenho, Eliana & Miraldo, Marisa & Propper, Carol & Walsh, Brendan, 2021. "The importance of surgeons and their peers in adoption and diffusion of innovation: An observational study of laparoscopic colectomy adoption and diffusion in England," Social Science & Medicine, Elsevier, vol. 272(C).
    16. 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.
    17. Jalali, Mohammad S. & Rahmandad, Hazhir & Bullock, Sally Lawrence & Lee-Kwan, Seung Hee & Gittelsohn, Joel & Ammerman, Alice, 2019. "Dynamics of intervention adoption, implementation, and maintenance inside organizations: The case of an obesity prevention initiative," Social Science & Medicine, Elsevier, vol. 224(C), pages 67-76.
    18. Abdülkadi̇r Ci̇van & Bülent Köksal, 2010. "The effect of newer drugs on health spending: do they really increase the costs?," Health Economics, John Wiley & Sons, Ltd., vol. 19(5), pages 581-595, May.
    19. Karine Lamiraud & Stéphane Lhuillery, 2015. "Endogenous Technology Adoption and Medical Costs," Working Papers hal-01218064, HAL.
    20. Sopany Saing & Naomi van der Linden & Christopher Hayward & Stephen Goodall, 2019. "Why is There Discordance between the Reimbursement of High-Cost ‘Life-Extending’ Pharmaceuticals and Medical Devices? The Funding of Ventricular Assist Devices in Australia," Applied Health Economics and Health Policy, Springer, vol. 17(4), pages 421-431, August.

    More about this item

    Statistics

    Access and download statistics

    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:spr:aphecp:v:19:y:2021:i:2:d:10.1007_s40258-020-00610-8. 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: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    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.