NICE Innovation

England's National Institute for Health and Clinical Excellence (NICE) announced last week that it has commissioned Professor Sir Ian Kennedy to conduct a study on 'valuing innovation.' Evidence for the report will consist of written submissions and information gathered from workshops with interested parties. How 'innovation' and 'value' are defined, measured, and related to each other will be the subjects of the study.

What this study reports should be instructive to the progress of U.S. health care policy for a couple reasons. For one, U.S. health reform efforts require systemic cost reduction and comparative effectiveness assessment of medical interventions in order for universal coverage to be affordable. An inevitable part of these processes is the evaluation of new medical technologies. How their 'value' is defined and measured is tricky business, and likely to upset more interest groups than it pleases. The NICE commission gives us a glimpse of what pitfalls lie ahead.

A second point of interest will be the NICE commission's definition of 'innovation' and assessment of its cost. Medical technology innovation is dominated by the United States, where much more money, researchers, and institutions are committed to the discovery and commercial development of novel diagnostics and therapies than anywhere else in the world. This fundamentally changes how the U.K. and the U.S. value innovation in their respective countries, because the U.K. (along with many other countries) eventually benefit from successful innovations without proportional contribution to the costs of necessary failures. It will be interesting to see if and how this is addressed in the NICE report.

In previous posts, I have argued that health technology innovation is essential for maintenance of and universal access to affordable, quality health care. I hope that innovation value studies such as NICE's, and others surely to follow, will be used to improve the efficiency of innovation, and not to fuel efforts that arrest innovation or limit its utility.