Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore.
Int J Technol Assess Health Care. 2023 Jan 11;39(1):e4. doi: 10.1017/S026646232200335X.
Based on a real-world collaboration with innovators in applying early health economic modeling, we aimed to offer practical steps that health technology assessment (HTA) researchers and innovators can follow and promote the usage of early HTA among research and development (R&D) communities.
The HTA researcher was approached by the innovator to carry out an early HTA ahead of the first clinical trial of the technology, a soft robotic sock for poststroke patients. Early health economic modeling was selected to understand the potential value of the technology and to help uncover the information gap. Threshold analysis was used to identify the target product profiles. Value-of-information analysis was conducted to understand the uncertainties and the need for further research.
Based on the expected price and clinical effectiveness by the innovator, the new technology was found to be cost-saving compared to the current practice. Risk reduction in deep vein thrombosis and ankle contracture, the incidence rate of ankle contracture, the compliance rate of the new technology, and utility scores were found to have high impacts on the value-for-money of the new technology. The value of information was low if the new technology can achieve the expected clinical effectiveness. A list of parameters was recommended for data collection in the impending clinical trial.
This work, based on a real-world collaboration, has illustrated that early health economic modeling can inform medical innovation development. We provided practical steps in order to achieve more efficient R&D investment in medical innovation moving forward.
基于与应用早期卫生经济建模的创新者的真实合作，我们旨在提供实用步骤，使卫生技术评估（HTA）研究人员和创新者能够遵循，并促进研发（R&D）社区对早期 HTA 的使用。
创新者联系 HTA 研究人员，在该技术的首次临床试验之前进行早期 HTA，该技术是一种用于中风后患者的软机器人袜子。选择早期卫生经济建模是为了了解技术的潜在价值，并帮助揭示信息差距。阈值分析用于确定目标产品特征。价值信息分析用于了解不确定性和进一步研究的需求。
基于创新者预期的价格和临床效果，与当前实践相比，新技术被发现具有成本效益。深静脉血栓形成和踝关节挛缩风险降低、踝关节挛缩发生率、新技术的依从率以及效用评分被发现对新技术的性价比具有重大影响。如果新技术能够达到预期的临床效果，信息的价值就很低。建议在即将进行的临床试验中收集一系列参数。
这项基于真实合作的工作表明，早期卫生经济建模可以为医疗创新发展提供信息。我们提供了实用步骤，以便在未来更有效地投资于医疗创新研发。
