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Closing the cycle of innovation in healthcare in Europe

Published online by Cambridge University Press:  17 January 2020

Frank Hulstaert Open the ORCID record for Frank Hulstaert [Opens in a new window] ,
Alric Ruether Open the ORCID record for Alric Ruether [Opens in a new window] ,
Jacques Demotes  and
Øyvind Melien
Frank Hulstaert*
Affiliation:
Belgian healthcare knowledge centre (KCE), Brussels, Belgium
Alric Ruether
Affiliation:
International Affairs, Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG), Cologne, Germany
Jacques Demotes
Affiliation:
European Clinical Research Infrastructure Network (ECRIN), Paris, France
Øyvind Melien
Affiliation:
Reviews and HTA, Norwegian Institute of Public Health, Chair of the Clinical Research Initiative for Global Health (CRIGH), Oslo, Norway
*
Author for correspondence: Frank Hulstaert, E-mail: [email protected]
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Abstract

Pragmatic or practice-oriented comparative effectiveness trials may be conducted to fill the evidence gaps that are revealed after the private sector has performed the trials needed for bringing their product to the market. A tool of increasing importance to identify such evidence gaps is resulting from health technology assessments (HTA) whereby the data derived from clinical research are examined in a systematic manner with reference to effect, safety, as well as additional parameters. Practice-oriented trials are informative for healthcare decision makers, practice-changing and may even be cost-saving for the healthcare payers. There are however only a limited number of funding sources for such trials. Public and private healthcare payers should stimulate the conduct of practice-oriented trials in their effort to maximize patient benefit within the limitation of the available resources. Pragmatic randomized trials can be performed at low cost when based on existing coded electronic health records and as well health registries. Public health decision makers are increasingly taking advantage of results from health technology assessments to support priority setting. In accordance with this it would appear reasonable that decision makers should get more involved in priority setting and funding also in the field of clinical research in order to provide further evidence needed for assessments, reassessments, and subsequent qualified decisions and resource allocations in health care. A closer dialogue and collaboration between the clinical research and HTA communities would facilitate a more efficient utilization of such opportunities.

Keywords

Comparative effectivenesshealth technology assessmentinnovation in healthcarepragmatic trials
Type
Article Commentary
Information
International Journal of Technology Assessment in Health Care , Volume 36 , Issue 2 , April 2020 , pp. 75 - 79
Copyright
Copyright © Cambridge University Press 2020

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