Journal
MEDICAL DECISION MAKING
Volume 37, Issue 2, Pages 139-147Publisher
SAGE PUBLICATIONS INC
DOI: 10.1177/0272989X16653397
Keywords
health economics methods; decision analysis; economic evaluation; cost-effectiveness analysis
Funding
- Chief Scientist's Office of the Scottish Government Health and Social Care Directorates
- Vancouver Coastal Health Authority
- National Institute for Health Research (NIHR) Health Technology Assessment Program [09/146/01]
- Chief Scientist Office [CZH/4/971, HERU1, HSRU1] Funding Source: researchfish
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At a time of intense pressure on health care budgets, the technology management challenge is for disinvestment in low-value technologies and reinvestment in higher value alternatives. The aim of this article is to explore ways in which health economists might begin to redress the observed imbalance between the evaluation of new and existing in-use technologies. The argument is not against evaluating new technologies but in favor of the search for efficiency, where the ultimate objective is to identify reallocations that improve population health in the face of resource scarcity. We explore why in-use technologies may be of low value and consider how economic evaluation analysts might embrace a broader efficiency lens, first through technology management (a process of analysis and evidence-informed decision making throughout a technology's life cycle) and progressing through pathway management (the search for efficiency gains across entire clinical care pathways). A number of model-based examples are used to illustrate the approaches.
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