Promoting healthcare innovation on the demand side
Promoting healthcare innovation on the demand side
复制标题
推动需求侧医疗创新
DOI：
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发表时间：
2016
影响因子：
3.4
通讯作者：
W. Price
中科院分区：
文献类型：
--
作者：
R. Eisenberg;W. Price
创新政策通常侧重于通过向开发和销售新产品的公司提供利润丰厚的权利以将竞争对手排除在市场之外来加强其激励。监管机构也依赖这些公司以及类似的激励措施来开发关于其产品对患者影响的信息，尽管他们之间存在明显的利益冲突。其结果可能是一种扭曲的理解，导致过度使用昂贵的新医疗技术。最近的技术进步使医疗保健支付者处于有利地位，可以在未来的创新中发挥更大的作用，以改善医疗保健并降低其成本。保险公司和综合医疗保健提供商拥有关于医疗保健提供和结果的数据宝库，这些数据可以产生关于医疗效果的宝贵见解，而无需进行昂贵的临床试验。一些综合医疗保健系统已经抓住了这一优势，对改变护理标准的特定产品的影响做出了显着的发现。此外，在医疗保健支付者可以从降低成本中获利的范围内，他们将寻求避免不适当地使用昂贵的技术。因此，支付者更多地参与医疗保健创新，可能会抵消产品销售者过度使用昂贵新产品的激励。近年来，联邦政府一直在寻求通过一系列举措中的医疗记录分析来促进创新;一些人将保险公司视为被动的数据存储库，而另一些人则为保险公司提供了在创新中发挥更积极作用的机会。在本文中，我们研究的作用，健康保险公司在发展新的知识提供和影响的医疗保健，我们称之为“需求侧创新”。我们解决的轮廓，这个未充分探索的创新领域，并描述参与企业的行为。我们研究了当前法律的规则对需求方创新的影响，包括保险监管、知识产权规则、隐私保护和FDA对新医疗保健技术的监管。在整个过程中，我们强调了政府可以使用的许多政策工具，并正在使用这些工具来促进传统专利和专有权工具包之外的付款人创新。
Abstract Innovation policy often focuses on fortifying the incentives of firms that develop and sell new products by offering them lucrative rights to exclude competitors from the market. Regulators also rely on these same firms—and on similar incentives—to develop information about the effects of their products in patients, despite their obvious conflict of interest. The result may be a distorted understanding that leads to overuse of expensive new medical technologies. Recent technological advances have put healthcare payers in an excellent position to play a larger role in future innovation to improve healthcare and reduce its costs. Insurance companies and integrated healthcare providers have custody of treasure troves of data about healthcare provision and outcomes that can yield valuable insights about the effects of medical treatment without the need to conduct costly clinical trials. Some integrated healthcare systems have seized upon this advantage to make notable discoveries about the effects of particular products that have changed the standard of care. Moreover, to the extent that healthcare payers can profit from reducing costs, they will seek to avoid inappropriate use of costly technologies. Greater involvement of payers in healthcare innovation thus offers a potential counterweight to the incentives of product sellers to promote excessive use of costly new products. In recent years, the federal government has sought to promote innovation through analysis of healthcare records in a series of initiatives; some picture insurers as passive data repositories, while others provide opportunities for insurers to take a more active role in innovation. In this paper, we examine the role of health insurers in developing new knowledge about the provision and effects of healthcare—what we call ‘demand-side innovation’. We address the contours of this underexplored area of innovation and describe the behavior of participating firms. We examine the effects of current legal rules on demand-side innovation, including insurance regulation, intellectual property rules, privacy protections, and FDA regulation of new healthcare technologies. Throughout, we highlight many policy tools that government can use and is using to facilitate payer innovation outside the traditional toolkit of patents and exclusive rights.
影响因子：
11.8
作者：
Volk, Jonathan E.;Marcus, Julia L.;Hare, C. Bradley
通讯作者：
Hare, C. Bradley