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76INNOVATION UKINNOVATION First experiences of setting up an economic value assessment of medical device innovations with healthcare decision- makers using a spreadsheet tool. By M. P. Craven, S. P. Morgan, J. A. Crowe and B. Lu Innovation - what's it worth? Early stage evaluation of medical device innovations is important for healthcare decision- makers as much as for manufacturers, meaning that a wider application of a basic cost- effectiveness analysis is becoming neces-sary outside the usual expert base of health technology assessment specialists. Resulting from an academic- industry- healthcare profes-sional collaboration, a spreadsheet tool is described that was designed to be accessible both to professionals in healthcare delivery organisations and to innovators in the healthcare technology industry who are non- experts in the field of health economics. The tool enables a basic cost- effectiveness analysis to be carried out, using a sim-plified decision- tree model to compare costs and patient benefit for a new device- related procedure with that of standard care employing an incumbent device or other alternative. Such a tool is useful to: » » Healthcare professionals - because it enables them to rapidly elucidate the cost- effectiveness of heterogeneous innovations by means of the standard quality adjusted life year ( QALY) measure of clinical outcome, which is intended to be broadly comparable across treatments. » » Innovator or manufacturer - it helps them focus on what is required for future stages of development, in order to fill gaps in the input data and so further strengthen their case from a health economics perspective. Results are presented of first experiences from deploying the tool on three medical device exemplars, in face- to-face meetings of the NHS National Innovation Centre ( NIC) along with the innovator or clinical champion. The results show that mapping of device- related innova-tions to the tool is achievable in a short meeting between the NIC and the innovator using expected costs, out-comes data from the literature and estimates of ranges for unknown input data. Whilst the result of a simplified analysis is not expected to be definitive, the process of reasoning is found to be illuminating for the parties involved, enabling innovators to articulate the benefits of their innovations and for all Healthcare match

UKINNOVATION UK77 parties to highlight gaps in data and evidence that will be required to take the innovation forward. The partnership model of the authors' organisation supports the kind of co- operative design approach that is necessary to pro-duce the kind of tool described. Economic evaluation is commonplace in the assessment of therapies involving drugs and medical devices. In the UK, in the National Health Service ( NHS) context, a cost-effectiveness analysis ( CEA) is an important component of health technology assessments of treatments that are carried out for organisations such as the National Insti-tute for Health and Clinical Excellence ( NICE) of England and Wales, Quality Improvement Scotland ( QIS) and the Department of Health, Social Services and Public Safety Northern Ireland ( DHSSPNI). The need for increased capacity in the NHS to assess value through consideration of both costs and benefits is growing. At the local level, primary and acute hospital trusts are already tasked to demonstrate the quality of care through value indicators1. Acting on the outcomes of the Healthcare Industries Task Force ( HITF) 2,3, the Purchasing and Supply Agency ( PASA) is now carrying out its own reviews and analysis of economic evidence of products through the Centre for Evidence- based Purchas-ing ( CEP). Furthermore, the launch of the National Innovation Cen-tre ( NIC), another HITF initiative, has made pertinent the need for accessible tools to enable decision- makers to assess new healthcare technologies that are disclosed to them. The NIC aims to speed up the development of pre- commercial technologies likely to benefit the NHS, and has already produced a set of web- based tools to help innovators. In particular, the NIC's Scorecard tool4 provides an auto-matically generated self- assessment and also allows the innovation to be submitted for review by NIC experts if necessary. Scorecard is therefore a gateway to the inno-vation's detailed assessment, such that if a submission meets an NIC priority, an innovator may be offered a deeper due- diligence service ( covering IP, legal, commer-cial and financial aspects) with the aim of building a full business case. As a measure of the take- up of such tools, in August 2008 the NHS National Innovation Centre had received 151 submissions of an idea to its Scorecard tool and 500 out of the 939 registered individuals had used it for their own use without submitting it to NIC. Resulting from this focus on accelerating the adoption of innovations into the NHS, technology businesses that are developing new medical devices for sale in the NHS are being encouraged to think about cost- effectiveness analysis at an ever earlier stage in the innovation process. To assist with this, the UK- based research programme Multidisciplinary Assessment of Technology Centre for Healthcare ( MATCH) 5 is collaborating with the NIC to develop and validate a new tool that is intended to be suitable for non- expert health economists to carry out, with minimal assistance, a basic cost- effectiveness assess-ment of their innovation. The prototype tool was developed within the MATCH programme and has recently been made available to all its partners with an expectation for wider dissemination. The tool we describe is aimed at early stage cost- effective-ness which would ideally be applied after the NIC's Score-card gateway. The following sections will describe the function of the tool, and present the results of research with three examples where it has been used to deter-mine an estimate of cost effectiveness during meetings of Healthcare match