Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-26T15:33:11.878Z Has data issue: false hasContentIssue false

MEDICAL DEVICE PRICES IN ECONOMIC EVALUATIONS

Published online by Cambridge University Press:  20 May 2015

Ilke Akpinar
Affiliation:
Institute of Health Economics iakpinar@ihe.ca
Philip Jacobs
Affiliation:
Institute of Health Economics
Don Husereau
Affiliation:
Institute of Health Economics

Abstract

Objectives: Economic evaluations, although not formally used in purchasing decisions for medical devices in Canada, are still being conducted and published. The aim of this study was to examine the way that prices have been included in Canadian economic evaluations of medical devices.

Methods: We conducted a review of the economic concepts and implications of methods used for economic evaluations of the eleven most implanted medical devices from the Canadian perspective.

Results: We found Canadian economic studies for five of the eleven medical devices and identified nineteen Canadian studies. Overall, the device costs were important components of total procedure cost, with an average ratio of 44.1 %. Observational estimates of the device costs were obtained from buyers or sellers in 13 of the 19 studies. Although most of the devices last more than 1 year, standard costing methods for capital equipment was never used. In addition, only eight studies included a sensitivity analysis for the device cost. None of the sensitivity analyses were based on actual price distributions.

Conclusions: Economic evaluations are potentially important for policy making, but although they are being conducted, there is no standardized approach for incorporating medical device prices in economic analyses. Our review provides suggestions for improvements in how the prices are incorporated for economic evaluations of medical devices.

Type
Methods
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Medical Device Industry Profile 2013. Ottawa: Industry Canada. https://www.ic.gc.ca/eic/site/lsg-pdsv.nsf/eng/h_hn01736.html (accessed October 3, 2014).Google Scholar
2. Health Canada. Medical Devices. http://www.hc-sc.gc.ca/dhp-mps/md-im/index-eng.php (accessed October 3, 2014).Google Scholar
3. B.C. Ministry of Health Technology Review. http://www.health.gov.bc.ca/htr/ (accessed November 3, 2014).Google Scholar
4. Alberta Health Technologies Decision Process. (accessed November 3, 2014). http://www.health.alberta.ca/initiatives/AHTDP.html (accessed November 3, 2014).Google Scholar
6. The Canadian Agency for Drugs and Technologies in Health. www.cadth.ca (accessed October 15, 2014).Google Scholar
7. Robinson, JC, Bridy, AM. Confidentiality and transparency in medical devices: Market dynamics and policy alternatives. Berkeley, CA: Berkeley Center for Health Technology; 2009.Google Scholar
8. McIntyre, DA. The eleven most implanted medical devices in America. 24/7 Wall Street. http://247wallst.com/healthcare-economy/2011/07/18/the-eleven-most-implanted-medical-devices-in-america/3/ (accessed October 15, 2014).Google Scholar
9. Drummond, MF, O’Brien, BJ, Stoddart, GL, Torran, GW. Methods for the economic evaluation of health care programmes. Oxford: Oxford University Press; 2005:75.Google Scholar
10. Brophy, JM, Erickson, LJ. Cost-effectiveness of drug-eluting coronary stents in Quebec, Canada. Int J Technol Assess Health Care. 2005; 21:326333.Google Scholar
11. Goeree, R, Bowen, JM, Blackhouse, G, et al. Economic evaluation of drug-eluting stents compared to bare metal stents using a large prospective study in Ontario. Int J Technol Assess Health Care. 2009;25:196207.CrossRefGoogle ScholarPubMed
12.Le May, MR, Davies, RF, Labinaz, M, et al. Hospitalization costs of primary stenting versus thrombolysis in acute myocardial infarction: cost analysis of the Canadian STAT. Circulation. 2003;108:26242630.Google Scholar
13. Poulin, F, Rinfret, S, Gobeil, F. Potential shift from coronary bypass surgery to percutaneous coronary intervention for multivessel disease and its economic impact in the drug-eluting stent era. Can J Cardiol. 2007; 23:11391145.Google Scholar
14. Rinfret, S, Cohen, DJ, TahamiMonfared, AA, et al. Cost effectiveness of the sirolimus-eluting stent in high-risk patients in Canada: an analysis from the C-SIRIUS trial. Am J Cardiovasc Drugs. 2006; 6:159168.Google Scholar
15. Shrive, FM, Manns, BJ, Galbraith, PD, Knudtson, ML, Ghali, WA; APPROACH Investigators. CMAJ. Economic evaluation of sirolimus-eluting stents. 2005;172:345351.Google Scholar
16. Wang, X, Rokoss, M, Dyub, A, Gafni, A, Lamy, A. Cost comparison of four revascularisation procedures for the treatment of multivessel coronary artery disease. J Med Econ. 2008;11:119134.Google Scholar
17. Wijeysundera, HC, Tomlinson, G, Ko, DT, Dzavik, V, Krahn, MD. Medical therapy v. PCI in stable coronary artery disease: a cost-effectiveness analysis. Med Decis Making. 2013;33:891905.Google Scholar
18. Filion, KB, Xie, X, van der Avoort, CJ, Dendukuri, N, Brophy, JM. Microvolt T-wave alternans and the selective use of implantable cardioverter defibrillators for primary prevention: a cost-effectiveness study. Int J Technol Assess Health Care. 2009;25:151160.CrossRefGoogle ScholarPubMed
19. Healey, JS, Dorian, P, Mitchell, LB, et al; CREDIT Investigators. Canadian Registry of ICD Implant Testing procedures (CREDIT): current practice, risks, and costs of intraoperative defibrillation testing. J Cardiovasc Electrophysiol. 2010;21:177182.CrossRefGoogle ScholarPubMed
20. Krahn, AD, Hoch, JS, Rockx, MA, et al. Cost of preimplantation cardiac imaging in patients referred for a primary-prevention implantable cardioverter-defibrillator. Am J Cardiol. 2008;102:588592.Google Scholar
21. O’Brien, BJ, Connolly, SJ, Goeree, R, et al. Cost-effectiveness of the implantable cardioverter-defibrillator: results from the Canadian Implantable Defibrillator Study (CIDS). Circulation. 2001;103:14161421.Google Scholar
22. Antoniou, J, Martineau, PA, Filion, KB, et al. In-hospital cost of total hip arthroplasty in Canada and the United States. J Bone Joint Surg Am. 2004;86:24352439.Google Scholar
23. Bourne, RB, Rorabeck, CH, Laupacis, A, et al. A randomized clinical trial comparing cemented to cementless total hip replacement in 250 osteoarthritic patients: The impact on health related quality of life and cost effectiveness. Iowa Orthop J. 1994;14:108114.Google Scholar
24. Laupacis, A, Bourne, R, Rorabeck, C, et al. Costs of elective total hip arthroplasty during the first year. Cemented versus noncemented. J Arthroplasty. 1994;9:481487.Google Scholar
25. Gillis, AM. The impact of pulse generator longevity on the long-term costs of cardiac pacing. Pacing Clin Electrophysiol. 1996;19:14591468.Google Scholar
26. O’Brien, BJ, Blackhouse, G, Goeree, R, et al. Cost-effectiveness of physiologic pacing: Results of the Canadian Health Economic Assessment of Physiologic Pacing. Heart Rhythm. 2005;2,270275.Google Scholar
27. Rinfret, S, Cohen, DJ, Lamas, GA, et al. Cost-effectiveness of dual-chamber pacing compared with ventricular pacing for sinus node dysfunction. Circulation. 2005;111:165172.CrossRefGoogle ScholarPubMed
28. Jansen, LA, Macadam, SA. The use of AlloDerm in postmastectomy alloplastic breast reconstruction: Part II. A cost analysis. Plast Reconstr Surg. 2011;127:22452254.Google Scholar
29. United States Government Accounting Office. MEDICARE lack of price transparency may hamper hospitals’ ability to be prudent purchasers of implantable medical devices. Washington, DC: GAO Report 12126 January 2012.Google Scholar