Show the Benefits of Medical Devices Using Health Economics

medical device reimbursement

Integrating Health Economics into Medical Device Product Development

Healthcare costs continue to rise at rates higher than inflation.  Payers, such as Centers for Medicare and Medicaid Services (CMS), insurance carriers, and even provider purchasing organizations (e.g., a hospital purchasing group), need to control their costs; while users want the latest technology.  Before adopting new technologies or products, payers expect data which shows that the new product provides benefits which can’t be obtained with existing products.

Health Economics & Medical Devices

So how do you show benefits?  Enter… health economics, in which the investment in health is evaluated against the benefit derived.  In the medical device world, health economics requires you to demonstrate how spending money for this product benefits the patient and leads to lower total healthcare costs.  Examples, including the following:

  • Use of laparoscopic and arthroscopic procedures to replace large incision surgical procedures resulting in shorter surgeries, faster recovery times, shorter hospital stays, and quicker return to work or other activities.
  • Changes in orthopedic materials leading to longer wear/usage. Over the user’s lifetime, this results in fewer surgeries and greater personal activity which also leads to better health.
  • Controlling a chronic condition such as diabetes which can lead to reduced emergency intervention and delaying or minimizing long term problems such as diabetic neuropathy.
  • Automating lab procedures to free lab personnel from time consuming work and improving reproducibility.
  • Product design and packaging which enables a nurse to use the product more easily or reduces risk of infection.
  • Diagnostic tests which detect a condition earlier, leading to earlier treatment and improved outcomes.

You may feel that it is difficult for new products to obtain reimbursement.  That’s not necessarily true.  You have to demonstrate, with data, why the payer should cover the product.  Waiting until you are ready to launch your product, before evaluating the reimbursement impact, risks having a product which is not reimbursable or causing delays in delivering a revenue stream to your company.  To plan for reimbursement, consider the following.

  • Determine what type of reimbursement you expect and in what countries. If there are specific features needed in the product to obtain reimbursement, integrate them into your design inputs, so that the features are included in the final product design.
  • Identify the type of data needed for the submissions and how you plan to collect the information.
  • Build any needed studies, to demonstrate health economics, into your product development schedule. Where possible, combine health economics studies with usability or clinical studies, which is more efficient than running separate studies.
  • Determine whether you will commercially introduce the product prior to obtaining reimbursement approval(s), as part of your launch strategy.

Integrating health economics into product development takes planning.  However, early evaluation, inclusion of the requirements into your design inputs and usability or clinical studies, helps improve your success in obtaining reimbursement and successfully selling your product.