This is module 3, the Elements of Medical Technology Assessments. In the previous two modules, we discussed [COUGH] the uses and settings for medical technology assessment and the mean sources of data that can be used as inputs to the models. In module 3, we will discuss all the components of the model and the types of models that exist. In lesson 3.1.1 types of technology assessments, we briefly review the different types of technology assessments that can be performed. As we have previously discussed, one of the most important uses of a technology assessment is to inform important decisions. In other words, there's a variety of stakeholders that use the output or results of a technology assessment when making decisions. It could be manufacturers or medical device companies, or pharmaceutical companies deciding whether or not to continue to research and fund the project. It could be a regulatory agency or a insurance company deciding whether or not to reimburse or approve a product. Or it could even be a pharmaceutical or device company trying to determine how much trying to sell a product for. There's a variety of other decisions that could be informed by technology assessments as well. But what's important is that the technology assessment provides a reliable and valid set of information for the decision makers. Therefore there's been a toolkit or standard sets of tools and measurement approaches that have been developed for conducting technology assessments. In the most general sense, the technology assessment is the collection analysis and dissemination of information to the relevant party. Again, government regulators may want to see evidence before approving the product. Payers may want to see evidence of effectiveness or cost effectiveness before they will pay for it. And a physician and hospitals may want to see evidence before they're convinced to use, prescribe or buy a new technology. In order to provide this evidence, the consultant researcher or whoever's performing the technology assessment need to collect the right information throughout the process. As we discussed in the previous module, this could be clinical data, claims data or a variety of other types of data. After collecting the data, next the technology assessment needs to be conducted. There are four common types of technology assessments. The first is cost analysis, this simply considers the costs of the intervention or technology and compares one cost or set of costs to another. The second type is cost-effectiveness analysis. Here, the cost of the intervention relative to some outcome either a benefit or measure of effectiveness in natural units is compared. For example, the cost of a new pharmaceutical is compared to how effective that drug is in weight loss or extending length of life, or reducing length of stay in a hospital. A third type of technology assessment is a cost-benefit analysis. This is similar to cost-effectiveness analysis, instead with cost-benefit analysis however, a dollar value is placed on the benefits rather than measuring them in natural units or in units of health. The fourth type of common technology assessment is a cost-utility analysis. In this type of analysis a measure of quality of life is incorporated with the financial measures of cost. This is similar to the cost-effectiveness analysis in that there are health related measures or benefits that are incorporated. However, it takes into account the quality of life, not necessarily only the length of life. Two additional types of technology assessments related to the four, I just discussed are cost-minimization analysis and burden of disease analysis. Cost-minimization analysis is similar to cost analysis. While we're here rather than comparing costs, the goal is to minimize the total cost. This can only be used when outcomes of the treatments being compared are similar. The other technology assessment is burden of disease analysis. In this type of analysis, the impact of a disease on mortality, morbidity or quality of life is assessed over a population. For example, malaria results in x number of lost life years. In a technology that reduces the probability or spread of malaria would have a total impact on a population of the number of life years lost per person times the number of people in the population. There are also multiple approaches to incorporating quality of life and to this type of study. And other technology assessments which we'll discuss in later lessons. No matter which type of health technology assessment is being conducted, there is some general principles to keep in mind when conducting any analysis. First, consider the audience and the perspective of the analysis. For example, is the audience the FDA, because the results will be included in a regulatory submission. Or is the audience a payer, because you're trying to encourage this payer or convince this payer to cover a new technology? It's important to understand this, before even beginning the assessment. Because the audience matters for how the results are presented. And can determine which type of technology assessment should be conducted to begin with. Second, when considering the perspective, it could be from the patient perspective or the societal perspective, or some other perspective. It's important to know this, because the perspective that the analysis is being conducted from will help determine which costs and benefits to measure and how to measure them. The second principle to keep in mind is that the assessment should be unbiased and transparent. In other words, it should be clear what was done and why. Just because there's a specific audience and perspective to the analysis does not mean that there will be a specific result guaranteed. The third principal to keep in mind is that the assessment should use as much timely data as possible. Remember, the results of this technology assessment are being used to make important decisions. So using as much timely relevant data as available, will allow decision makes to make the best decision they can.
