Utilization of innovative medical technologies in German inpatient care: does evidence matter?
Health Res Policy Syst
; 21(1): 100, 2023 Oct 02.
Article
en En
| MEDLINE
| ID: mdl-37784100
ABSTRACT
BACKGROUND:
The reimbursement of new technologies in inpatient care is not always linked to a requirement for evidence-based evaluation of patient benefit. In Germany, every new technology approved for market was until recently eligible for reimbursement in inpatient care unless explicitly excluded. The aim of this work was (1) to investigate the type of evidence that was available at the time of introduction of 25 innovative technologies and how this evidence evolved over time, and (2) to explore the relationship between clinical evidence and utilization for these technologies in German inpatient care.METHODS:
This study combined different methods. A systematic search for evidence published between 2003 and 2017 was conducted in four bibliographic databases, clinical trial registries, resources for clinical guidelines, and health technology assessment-databases. Information was also collected on funding mechanisms and safety notices. Utilization was measured by hospital procedures captured in claims data. The body of evidence, funding and safety notices per technology were analyzed descriptively. The relationship between utilization and evidence was explored empirically using a multilevel regression analysis.RESULTS:
The number of included publications per technology ranges from two to 498. For all technologies, non-comparative studies form the bulk of the evidence. The number of randomized controlled clinical trials per technology ranges from zero to 19. Some technologies were utilized for several years without an adequate evidence base. A relationship between evidence and utilization could be shown for several but not all technologies.CONCLUSIONS:
This study reveals a mixed picture regarding the evidence available for new technologies, and the relationship between the development of evidence and the use of technologies over time. Although the influence of funding and safety notices requires further investigation, these results re-emphasize the need for strengthening market approval standards and HTA pathways as well as approaches such as coverage with evidence development.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
Problema de salud:
1_geracao_evidencia_conhecimento
/
1_medicamentos_vacinas_tecnologias
Asunto principal:
Evaluación de la Tecnología Biomédica
/
Pacientes Internos
Tipo de estudio:
Clinical_trials
/
Guideline
/
Health_technology_assessment
Límite:
Humans
País/Región como asunto:
Europa
Idioma:
En
Revista:
Health Res Policy Syst
Año:
2023
Tipo del documento:
Article
País de afiliación:
Alemania