Exemplar studies in assessing the value of innovative medical devices for adoption within the NHS

This 11 month collaborative proposal between the Multidisciplinary Assessment of Technology Centre for Healthcare (MATCH) and the NHS aims to determine how health economic approaches can be used most effectively to assess value for the purposes of procurement and innovation assessment decision-making. The research is based on health economic study of a set of exemplars that have been chosen to cover three important classes of device-related purchases that are encountered by the Purchasing and Supply Agency (PASA): incremental technologies, disruptive technologies and 'packages of care', A further three exemplars are medical device innovations that the National Innovation Centre (NIC) wishes to evaluate. Methods we will employ include short run versions of cost-utility evaluations based on Quality-of-life Adjusted Life Years that are used by health technology assessment bodies like the National Institute for Heath and Clinical Excellence. Alternatives we will investigate include cost-benefit 'Willingness to Pay' methods. Most importantly, both kinds of health economic evaluation method aim to balance patient benefit or preference against cost when determining the value of an innovation.The context for this research is the problem faced by the National Health Service in making appropriate decisions about the purchase of innovative healthcare devices in an environment of severe budgetary constraints and alongside ambitious national and regional healthcare priorities. Whilst is it clear that 'value for money' should always include evidence of clinical effectiveness relating to the choices made, without a full integration of patient outcomes and/or clinical opinion into the procurement framework, adoption of innovations can easily become a victim of purchase at lowest cost. Alternatively, innovations that have been identified as improvers of healthcare may not be judged to be affordable, with a danger of wasting the huge resources being put into healthcare R&D. To ensure national relevance, the results of the studies will be disseminated across the NHS Institute for Innovation and Improvement, the NHS Collaborative Procurement Hubs, the Centre for Evidence-based Procurement, and the medical devices industry through the MATCH partnership. Consultation with the Association of British Healthcare Industries (ABHI) at the beginning of the project and their invitation to dissemination events will ensure additional industry engagement. Deliverables will include a report of the exemplar studies and national dissemination by means of a PASA/NIC workshop and a European Health Technology Assessment conference presentation. The work is strongly aligned to the objectives of the Healthcare Industries Task Force (HITF) that is being enacted by its Strategic Implementation Group.The proposal will also answer questions about approaches to innovation that are being raised in ongoing 'Promoting Disruptive Healthcare in the NHS' Steering Group meetings led by the Healthcare Engineering Group at Loughborough University and including representatives from both PASA and NIC, the ABHI, HaCIRIC and MATCH. It is anticipated that these relationships will be preserved and enhanced during the work proposed here. For MATCH, there is a unique opportunity to work with both sides of the innovation/procurement puzzle and to provide some underpinning, common view of, value. This is probably the first time that such an opportunity has arisen in the UK. Moreover, it would be impossible to conceive of this type of project in isolation - it would cost considerably more to conduct the whole programme as a piece of stand-alone research, but the value is effectively doubled by drawing on core MATCH funds and the partnership funding stream.