Evaluating high-cost technologies - no need to throw the baby out with the bathwater

Gurdeep S Sagoo, Tomos Robinson, Diarmuid Coughlan, Nick Meader, Stephen Rice, Luke Vale

Research output: Contribution to journalReview articlepeer-review


INTRODUCTION: Evidence generation for the health technology assessment (HTA) of a new technology is a long and expensive process with no guarantees that the health technology will be adopted and implemented into a health-care system. This would suggest that there is a greater risk of failure for a company developing a high-cost technology and therefore incentives (such as increasing the funding available for research or additional market exclusivity) may be needed to encourage development of such technologies as has been seen with many high-cost orphan drugs.

AREAS COVERED: This paper discusses some of the key issues relating to the evaluation of high-cost technologies through the use of existing HTA processes and what the challenges will be going forward.

EXPERT OPINION: We propose that while the current HTA process is robust, its evolution into accommodating the incorporation of real-world data and evidence alongside a life-cycle HTA approach should better enable developers to produce the evidence required on effectiveness and cost-effectiveness. This should lead to reduced decision uncertainty for HTA agencies to make adoption decisions in a more timely and efficient manner. Furthermore, budget impact analysis remains important in understanding the actual financial impact on health-care systems and budgets outside of the cost-effectiveness framework used to aid decision-making.

Original languageEnglish
Pages (from-to)1177-1183
Number of pages7
JournalExpert Review of Pharmacoeconomics & Outcomes Research
Issue number10
Publication statusPublished - 28 Sept 2023

Bibliographical note

Funding Information:
This paper was not funded.

Publisher Copyright:
© 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.


  • Humans
  • Technology, High-Cost
  • Uncertainty
  • Technology Assessment, Biomedical
  • Biomedical Technology
  • Orphan Drug Production
  • Cost-Benefit Analysis

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