By the same authors

The value of implementation and the value of information: combined and uneven development

Research output: Book/ReportCommissioned report



Publication details

DatePublished - Sep 2005
Number of pages22
PublisherCentre for Health Economics
Place of PublicationYork, UK
Original languageEnglish

Publication series

NameCHE Research Paper
PublisherCentre for Health Economics


Aim: In a budget constrained healthcare system the decision to invest in strategies to improve the implementation of cost-effective technologies must be made alongside decisions regarding investment in the technologies themselves and investment in further research. This paper presents a single, unified framework that simultaneously addresses the problem of allocating funds between these separate but linked activities. Methods: The framework presents a simple 4 state world where both information and implementation can be either at the current level or ‘perfect’. Through this framework it is possible to determine the maximum return to further research and an upper bound on the value of adopting implementation strategies. The framework is illustrated through case studies of health care technologies selected from those previously considered by the UK National Institute for Health and Clinical Excellence (NICE). Results: Through the case studies, several key factors that influence the expected values of perfect information and perfect implementation are identified. These factors include the maximum acceptable cost-effectiveness ratio, the level of uncertainty surrounding the adoption decision, the expected net benefits associated with the technologies, the current level of implementation and the size of the eligible population. Conclusions: Previous methods for valuing implementation strategies have confused the value of research and the value of implementation. This framework demonstrates that the value of information and the value of implementation can be examined separately but simultaneously in a single framework. This can usefully inform policy decisions about investment in healthcare services, further research and adopting implementation strategies which are likely to differ between technologies.

Bibliographical note

© 2005 Elisabeth Fenwick, Karl Claxton, Mark Sculpher. The full text of this report can be viewed free of charge from the Centre for Health Economics web site at:

    Research areas

  • value of information analysis, value of implementation, healthcare decision-making, Bayesian analysis

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