Health Technology Assessment (HTA) and the Incentives to Innovation in the Life Cycle of a Health Technology

  • Joan Rovira


The objective of this chapter is to explore how health technology assessment (HTA) can best be used to steer socially needed innovation in health technologies. To that end it is essential to analyse the driving factors in the life cycle of health technologies, i.e. the factors that determine how they are created, developed, regulated, used and, eventually, finally discarded, as well as the roles and motivations of the key stakeholders in this process. The next step is to design and implement the appropriate policies and institutional arrangements that provide the incentives required to ensure that the right amount and distribution of resources is applied to promote the development and use of new technologies that efficiently and equitably address existing social health needs. In order to do so, it is important to take a holistic approach that acknowledges the interactions between stakeholders and external factors in making the relevant decisions in the innovation process.


Visceral Leishmaniasis Health Technology Assessment Health Product Intellectual Property Right Compulsory License 
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  1. 1.
    Garber AM. To use technology better. Health Aff. (Millwood) 2006;25(2):w51-3. Available from: Last accessed June, 2014.
  2. 2.
    Schumpeter JA. Capitalism, socialism and democracy (1942). New York: Harper and Roe Publishers, 1942.Google Scholar
  3. 3.
    OECD. Oslo manual. Guidelines for collecting and interpreting innovation data. 3a ed. OECD Publications; 2005. Available from:
  4. 4.
    OECD. The measurement of scientific and technological activities proposed standard practice for surveys on research and experimental development. Frascati Manual 2002; Paris: OECD Publications; 2002. Available from:
  5. 5.
    Huot L, Decullier E, Maes-Beny K, Chapuis FR. Medical device assessment: scientific evidence examined by the French national agency for health - a descriptive study. BMC Public Health. 2012;12:585. Available from: Last accessed July, 2014.
  6. 6.
    Feldman MD, Petersen AJ, Karliner LS, Tice JA. Who is responsible for evaluating the safety and effectiveness of medical devices? The role of independent technology assessment. J Gen Intern Med. 2008;23 Suppl 1:57-63. Available from: Last accessed July, 2014.
  7. 7.
    Van Nooten F, Holmstrom S, Green J, Wiklund I, Odeyemi IAO, Wilcox TK. Health economics and outcomes research within drug development: challenges and opportunities for reimbursement and market access within biopharma research. Drug Discov Today. 2012;17(11-12):615-22. Available from: Last accessed July, 2014.
  8. 8.
    Kennedy I. Appraising the value of innovation and other benefits, A short study for NICE. 2009: p. 52. Available from:
  9. 9.
    Green C. Considering the value associated with innovation in health technology appraisal decisions (deliberations): a NICE thing to do? Appl Health Econ Health Policy. 2010;8(1):1-5. Available from: Last accessed July, 2014.
  10. 10.
    European Commission. Working Group on Pricing and Reimbursement C of the V of IM. Enterprise and Industry 2013. Available from: Last accessed June, 2014.
  11. 11.
    Grabowski HG, Wang YR. The quantity and quality of worldwide new drug introductions, 1982-2003. Health Aff (Millwood). 2006;25(2):452-60. Available from: Last accessed June, 2014.
  12. 12.
    Light DW, Lexchin J. Will lower drug prices jeopardize drug research? A policy fact sheet. Am J Bioeth. 2004;4(1):W1-4. Available from: Last accessed July, 2014.
  13. 13.
    Motola D, De Ponti F, Rossi P, Martini N, Montanaro N. Therapeutic innovation in the European Union: analysis of the drugs approved by the EMEA between 1995 and 2003. Br J Clin Pharmacol. 2005;59(4):475-8. Available from: Last accessed July, 2014.
  14. 14.
    Motola D, De Ponti F, Poluzzi E, Martini N, Rossi P, Silvani MC, et al. An update on the first decade of the European centralized procedure: how many innovative drugs? Br J Clin Pharmacol. 2006;62(5):610-6. Available from: Last accessed July, 2014.
  15. 15.
    Morgan SG, Bassett KL, Wright JM, Evans RG, Barer ML, Caetano PA, et al. “Breakthrough” drugs and growth in expenditure on prescription drugs in Canada. BMJ. 2005;331(7520):815-6. Available from: Last accessed July, 2014.
  16. 16.
    Lexchin J. How safe are new drugs? Market withdrawal of drugs approved in Canada between 1990 and 2009. Open Med. 2014;8(1):e14-e19. Available from:
  17. 17.
    Toole AA. Does Public Scientific Research Complement Private Investment in Research and Development in the Pharmaceutical Industry? J Law Econ [Internet]. University of Chicago Press. 2007;50(1):81-104. Available from: Last accessed July, 2014.
  18. 18.
    Toole AA. The impact of public basic research on industrial innovation: Evidence from the pharmaceutical industry. Res Policy. 2012;41(1):1-12. Available from: Last accessed July, 2014.
  19. 19.
    Barton JH, Emanuel EJ. The patents-based pharmaceutical development process: rationale, problems, and potential reforms. JAMA. 2005;294(16):2075-82. Available from:
  20. 20.
    Gold ER, Kaplan W, Orbinski J, Harland-Logan S, N-Marandi S. Are patents impeding medical care and innovation? PLoS Med. 2010;7(1):e1000208. Available from: Last accessed June 2014.
  21. 21.
    Rai AK. The ends of intellectual property: health as a case study. Law Contemp Probl. 2007;70(2):125-30.Google Scholar
  22. 22.
    Adang EMM. Economic evaluation of innovative technologies in health care should include a short-run perspective. Eur J Health Econ. 2008;9(4):381-4. Available from: Last accessed July 2014.
  23. 23.
    Nathan C. Aligning pharmaceutical innovation with medical need. Nat Med. 2007;13(3):304-8. Available from: Last accessed July 2014.
  24. 24.
    Rovira J. Intellectual property rights and pharmaceutical developmen. In: Costa-I-Font J, Courbage C, Mcguire A, editor. The economics of new health technologies – incentives, organisation and financing. Oxford: University Press; 2009. p. 219-40.Google Scholar
  25. 25.
    Mueller-Langer F. Neglected infectious diseases: are push and pull incentive mechanisms suitable for promoting drug development research? Health Econ Policy Law. 2013;8(2):185-208. Available from: Last accessed July 2014.
  26. 26.
    Tunis SR, Turkelson C. Using health technology assessment to identify gaps in evidence and inform study design for comparative effectiveness research. J Clin Oncol. 2012;30(34):4256-61. Available from: Last accessed July 2014.
  27. 27.
    Ladabaum U, Brill J V, Sonnenberg A, Shaheen NJ, Inadomi J, Wilcox CM, et al. How to value technological innovation: a proposal for determining relative clinical value. Gastroenterology. 2013;144(1):5-8. Available from: Last accessed July, 2014.
  28. 28.
    Warren BC. Flexible drug patent terms: a Proposed mechanism to stimulate global innovation and health 2013 Feb 28; Available from: Last accessed July 2014.
  29. 29.
    Del Llano J. Discussion point: should governments buy drug patents? Eur J Health Econ. 2007;8(2):173-7. Available from: Last accessed July 2014.
  30. 30.
    Weisbrod B. Solving the Drug Dilemma. Washington Post. New York; 2003; Available from:
  31. 31.
    Stiglitz J. Innovation: A better way than patents. New Sci. 2006;(2569):20. Available from:
  32. 32.
    Love J, Hubbard T. The big idea: prizes to stimulate R&D for new medicines. KEI Research Paper. 2007 p. 37. Available from:
  33. 33.
    Hollis A. An efficient reward system for pharmaceutical innovation. Calgary; 2004 p. 29. Available from:
  34. 34.
    Goldacre B. The drugs don’t work: a modern medical scandal. The Guardian 2012;20. Available from: Last accessed June 2014.
  35. 35.
    Longworth L, Youn J, Bojke L, Palmer S, Griffin S, Spackman E, et al. When does NICE recommend the use of health technologies within a programme of evidence development? a systematic review of NICE guidance. Pharmacoeconomics. 2013;31(2):137-49. Available from: Last accessed July 2014.
  36. 36.
    Persson U, Svensson J, Pettersson B. A new reimbursement system for innovative pharmaceuticals combining value-based and free market pricing. Appl Health Econ Health Policy. 2012;10(4):217-25. Available from:
  37. 37.
    Baker D. Financing drug research: what are the issues? Washington, DC; 2004 p. 27. Available from:

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Joan Rovira
    • 1
  1. 1.Department of EconomicsUniversity of BarcelonaBarcelonaSpain

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