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The Kennedy report: Appraising the value of innovation and other benefits
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What qualifies as an innovation?
When arguing that a different cost-effectiveness threshold should apply to certain ‘innovative’ technologies, Kennedy argues that a qualifying product must:
- Be new
- Constitute an improvement on existing products
- Provide a step change in patient outcomes, with a further requirement that:
- The product significantly and substantially improves the way that a current need (including supportive care) is met
- The need met is one that the NHS has identified as being important
- Appropriate research on stratification has identified the population in which the product is effective
- Appropriate effectiveness has been demonstrated—e.g. the product will benefit 70% of the intended group
- The product has marketing authorisation for the particular indication
Thus, an innovation is a new licensed technology that meets an NHS priority need and has a substantial impact on the outcomes of at least 70% of indicated patients, who can be reliably and prospectively identified.
In offering an operational definition of innovation, Kennedy demonstrates an underlying problem with the paying-for-innovation argument. Innovation can be differentiated from mere invention by its production of outcomes that are valued—in this case by the NHS (on society’s behalf). If healthcare rather than health is to be valued within cost effectiveness, then what important elements of healthcare remain to justify a higher threshold? The only way that a higher threshold appears relevant is if there are additional benefits beyond those judged by patients, and the argument here hangs on the contribution that innovation makes to the wider economy. If so, should it be the role of the Department of Health to fund an essentially industrial policy?
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Taken from the Issue 9/September 2009 issue of Cancer Services Forum.
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Discussion.