The Issue
New medical technology is a major contributor to the rising price of health care around the world. The United States spends twice as much per person as Europe does on medical devices and other health technologies, despite the lack evidence of commensurate gains in health outcomes. Most European countries consider value when determining which technologies to cover and at what price.
What the Study Found
The researchers conducting this Commonwealth Fund–supported study found that in most cases, the U.S. Centers for Medicare and Medicaid Services does not take into account a device’s comparative effectiveness or its cost relative to alternative treatment options when determining reimbursement. Coverage decisions are instead "based on poor or limited evidence from clinical studies," the authors write.
To bring U.S. spending on new medical technology more in line with its European counterparts include, the authors recommend:
- requiring companies to submit extensive evidence that new devices are safer and of greater therapeutic benefit than those already on the market;
- collect several years of data on the safety and comparative effectiveness of new devices once they are on the market to help determine pricing and coverage; and
- base reimbursement and copayment rates on the evidence-based value of devices.
Conclusions
Growth in the number and complexity of new medical devices is a major driver of rising health care costs. To stem the tide, the U.S. should rely more heavily on studies of the costs and effectiveness of new technologies to inform coverage, reimbursement, and pricing decisions.