Managed Care and the Evaluation and Adoption of Emerging Medical Technologies (Conference Proceedings) - Softcover

Garber, Steven

Softcover

ISBN 10: 0833028316 ISBN 13: 9780833028310

Publisher: RAND Corporation, 2000

Synopsis

New medical technologiespharmaceuticals, medical devices, and proceduresoften allow great improvements in the outcomes of medical care, but they are also widely believed to be a major cause of increasing costs. Selective adoption of new technologies is crucial in the quest to control health care costs while preserving or enhancing the quality of care.

About this title

From the Publisher

New medical technologies-pharmaceuticals, medical devices, andprocedures-often allow great improvements in the outcomes ofmedical care, but they are also widely believed to be a major cause ofincreasing costs. Selective adoption of new technologies, the takingon of only those technologies for which the medical benefits exceedthe costs to society of developing and using them, is a crucial ele-mentin the quest to control health care costs while preserving or en-hancingthe quality of care.This report focuses on adoption of innovative medical technologiesby managed care organizations (MCOs). The project had two primaryobjectives: (1) to understand current processes MCOs use for mak-ingcoverage, medical-necessity, and payment decisions involvingemerging medical technologies, and how device developers andmanufacturers prepare for and participate in these processes; and (2)to identify ways that private, voluntary action by the managed-careand medical-device industries individually or jointly might im-prove-for the benefit of society-the processes by which new medi-caltechnologies are developed, evaluated, and adopted or rejectedfor coverage.We gathered empirical information from in-depth, semi-structuredinterviews with eight manufacturers of innovative devices and ninemanaged care organizations. We also collected information fromrepresentatives of manufacturers, MCOs, and the sponsors of thisstudy-the California Goldstrike Partnership, the EconomicDevelopment Administration of the U.S. Department of Commerce,and the Health Industry Manufacturers Association (HIMA)-at ahalf-day, invitation-only meeting held at RAND headquarters onOctober 7, 1999.The most novel aspect of the study is collection of extensive infor-mationfrom manufacturers and juxtaposition of their reported expe-riencesand perspectives with those of MCOs. We had four primaryaudiences in mind when conducting this research and reporting ourfindings: medical-device developers and manufacturers, managedcare organizations, public-policy makers, and researchers and ana-lysts.Members of all four audiences will find something of interesthere. Experienced device manufacturers-i.e., companies that havealready marketed devices in the United States-may, for example, bespurred to think about marketing to MCOs in new ways. Aspiringdevice manufacturers-i.e., organizations that are attempting to de-velopinnovative devices but that have no experience in marketingsuch products-and their investors may learn the most. In particu-lar,many observers believe that such organizations often fail to lookpast Food and Drug Administration approval of their products to thechallenges they will face in the marketplace, and find themselves in-adequatelyprepared for the commercialization effort. Likewise, asMCOs attempt to make numerous difficult decisions regardingemerging technologies, they are likely to benefit from consideringthe perspectives of manufacturers and the processes and perspec-tivesof other MCOs. Public policies can influence MCO technology-adoptiondecisions for privately insured consumers. It would bebeneficial, then, for policymakers to consider how their decisionsmay affect medical innovation indirectly through the effects of thosedecisions on private technology adoption, along with the more ob-viousdirect effects of their decisions about coverage and paymentunder public health insurance programs. In addition, governmentagencies concerned with job creation and economic developmentshould be interested in our findings concerning determinants ofcommercial success for medical-technology developers and manu-facturers.Finally, researchers and analysts may be interested invarious issues discussed here, such as decisionmaking by MCOs, de-vicemanufacturers' commercialization strategies and tactics, howthe interaction of the two determines demand for emerging medicaltechnologies, and the nature of incentives for medical innovation.This report is based on research conducted under the auspices ofRAND Health. RAND Health furthers RAND's mission of helpingimprove policy and decisionmaking through research and analysis,by working to improve health care systems and advance understand-ingof how the organization and financing of care affect costs, qual-ity,and access.

About the Author

Steven Garber (Ph.D. (Economics) University of Wisconsin, Madison, August 1976) is a senior economist, Rand. Susan Ridgely (J.D., 1995, University of Maryland School of Law) is a CoInvestigator, UCLA/RAND Research Center on Managed Care and Psychiatric Disorders and a CoInvestigator, Rand Drug Policy Research Center.

Edition details

• Publisher: RAND Corporation
• Publication date: 2000
• ISBN 10: 0833028316
• ISBN 13: 9780833028310
• Binding: Paperback
• Language: English
• Number of pages: 70