A briefing on February 5, highlighted biomedical innovation ideas and articles appearing in the February issue of “Health Affairs” www.healthaffairs.org/content/34//2/294.abstract. Panel discussions were held on pharmaceuticals and biotechnology, accelerating and diffusing innovation, financing innovation, and on medical devices.
Julia Thornton Snider, PhD, Senior Research Economist at Precision Health Economics www.precisionhealtheconomics.com as one of the co-authors with Amitabh Chandra Professor of Public Policy at Harvard University’s John F. Kennedy School of Government www.hks.harvard.edu, summarized ideas from the article titled “Robot-Assisted Surgery for Kidney Cancer Increased Access to a Procedure that can Reduce Mortality and Renal Failure”.
As she explained, surgeons increasingly use robot-assisted minimally invasive surgery for a variety of medical conditions. The article examined the use of robot-assisted surgery for kidney cancer to determine the long-term value of not only to health but also the economic factors.
Generally kidney cancer is treated through partial (removal of only the diseased tissue) or radical nephrectomy (removal of the entire kidney). The authors found that robot-assisted surgery for kidney cancer increased the use of partial nephrectomy where it was found that by removing only the diseased kidney tissue versus removing the entire kidney led to improved kidney cancer outcomes.
They also found that robot-assisted surgery improved the quality-adjusted life years gained for patients and outweighed the healthcare and surgical costs to patients and payers by a ratio of five to one.
Jeffrey C. Lerner PhD, President and CEO ECRI Institute www.ecri.org discussed the article titled “Case Studies on Forecasting for Innovative Technologies”. He said, “Thought has to be given to how effective early forecasts can be, accuracy of forecasts, what variables contribute to inaccurate forecasts, and then how can forecasters manage the variables to improve accuracy.
The co-authors analyzed forecasts published by the ECRI institute on four technologies that included single-room proton beam radiation therapy for various cancers, digital breast tomosynthesis imaging technology for breast cancer, screening transcatheter aortic valve replacement for serious heart valve disease, and minimally invasive robot-assisted surgery for various cancers.
The forecasts studied were published between 2007 and 2010 by the ECRI Institute but the team also examined revised ECRI forecasts published in 2013, and 2014. The result was that five of twenty early predictions were inaccurate when compared with the updated forecasts. The case studies suggest that frequent revision of forecasts could improve accuracy especially for complex technologies where eventual use is governed by multiple interactive factors.
John D. Carroll, MD, Professor of Medicine in the Division of Cardiology and the Medical Director of the Cardiac and Vascular Center at the University of Colorado, School of Medicine, www.ucdenver.edu emphasized the vital need for the Transcatheter Valve Therapy Registry www.ncdr.com/TVT/Home/Default.aspx to help the many individuals experiencing heart valve diseases.
According to the article by Dr. Carroll and other co-authors, heart valve diseases are increasingly prevalent plus many elderly people have other comorbid conditions making them poor candidates for surgical treatment of heart valve diseases.
Since 2011, these patients have been eligible to receive new nonsurgical heart valve treatments approved by FDA and covered by Medicare. As a result, the Transcatheter Valve Therapy Registry now captures clinical information on all U.S patients undergoing new nonsurgical heart valve treatment.
The registry is a collaboration among professional societies, FDA, CMS, hospitals, patients, and the medical device industry. The registry supports Medicare coverage decisions, expands device indications, provides device surveillance, and establishes national quality benchmarks. Future goals include shortening the FDA-approval timeline for devices, providing data for decision-making tools for patients, and public reporting of hospital performance.