How to judge the value of innovation

The NHS chief executive’s report, Innovation Health and Wealth, which sets out the government’s current strategy on innovation in healthcare, highlights the importance of adopting innovative technologies in a rational way.1 Some new devices and diagnostics may offer important benefits to patients and health services, but it can be difficult to judge which they might be and to influence their uptake by clinicians and healthcare commissioners. Few of the many initiatives aimed at encouraging innovation have succeeded in driving the well reasoned adoption of new technologies.2 The poor evidence base for medical technologies (more so than for drugs) hampers decision making.3 Given current financial pressures that may deter the adoption of new technologies by payers, who are understandably reluctant to meet increased costs, how can a clear proposition be made for the value of a technology?

Medical technologies are often evaluated using limited evidence. This is partly because the regulation of medical devices worldwide does not require as much research data as does the regulation of drugs; partly because new technologies are often developed by small companies that have little experience in research; and partly because new technologies typically reach market early, before many research findings are available. More well conducted trials of medical devices are undoubtedly needed, …