05481nam 2200697 a 450 991081705840332120240417000206.01-280-20362-597866102036280-309-55594-90-585-17750-3(CKB)111004366660604(EBL)3377062(SSID)ssj0000119800(PQKBManifestationID)11128672(PQKBTitleCode)TC0000119800(PQKBWorkID)10072920(PQKB)11100905(MiAaPQ)EBC3377062(Au-PeEL)EBL3377062(CaPaEBR)ebr10063022(OCoLC)923267802(EXLCZ)9911100436666060419910412d1991 uy 0engur|n|---|||||txtccrThe Changing economics of medical technology /Annetine C. Gelijns and Ethan A. Halm, editors ; Committee on Technological Innovation in Medicine, Institute of Medicine1st ed.Washington, D.C. National Academy Press19911 online resource (224 p.)Medical innovation at the crossroads ;v. 2Proceedings of a workshop held Dec. 20-21, 1989, supported by the Howard Hughes Medical Institute and the Agency for Health Care Policy and Research of the Dept. of Health and Human Services (grant 5 R09 HS055 26 02).0-309-04491-X Includes bibliographical references and index.""The Changing Economics of Medical Technology""; ""Copyright""; ""Acknowledgments""; ""Preface""; ""Contents""; ""List of Abbreviations""; ""1 An Introduction to the Changing Economics of Technological Innovation in Medicine ""; ""A DYNAMIC MODEL OF TECHNOLOGICAL INNOVATION IN MEDICINE""; ""THE DYNAMICS OF PHARMACEUTICAL INNOVATION""; ""THE DYNAMICS OF DEVICE INNOVATION""; ""THE DYNAMICS OF SURGICAL INNOVATION""; ""INTERNATIONAL COMPARISONS: EUROPE AND JAPAN""; ""CONCLUDING OBSERVATIONS""; ""NOTES""; ""REFERENCES""; ""2 The Diffusion of New Technology: Costs and Benefits to Health Care """"HOW MUCH DOES NEW TECHNOLOGY ADD TO HEALTH CARE COSTS?""""OPTIMAL DIFFUSION OF TECHNOLOGY: THE COST-EFFECTIVENESS PRINCIPLE""; ""EFFECTS OF REIMBURSEMENT ON THE USE OF NEW TECHNOLOGIES""; ""Hospitals""; ""HMOs and Managed Care Plans""; ""Incentives for Fee-for-Service Physicians""; ""FUTURE DIRECTIONS: HOW TO ACHIEVE COST-EFFECTIVE DIFFUSION OF MEDICAL TECHNOLOGY""; ""NOTE""; ""REFERENCES""; ""3 The Changing Economics of Pharmaceutical Research and Development ""; ""CURRENT TRENDS""; ""R&D Opportunities""; ""R&D Costs""; ""Product Life Cycles""; ""Effective Patent Life""; ""Drug Prices""""RETURN TO PHARMACEUTICAL R&D""""IMPLICATIONS""; ""PUBLIC POLICY CONSIDERATIONS""; ""NOTES""; ""REFERENCES""; ""4 Public Policy and Access to New Drugs: The Case of Cancer Chemotherapy ""; ""CANCER CARE: A SERIES OF INCREMENTAL INNOVATIONS""; ""A PERIOD OF TRANSITION: FROM RAPID GROWTH TO STRICT CONTROL""; ""REIMBURSEMENT POLICIES AND THEIR EFFECT ON THE USE OF NEW TECHNOLOGIES""; ""The Effects of the Prospective Payment System""; ""The Dis-Integration of Care""; ""Growing Patterns of Denial of Payment""; ""Off-Label Use and New Indications""; ""Payment for Investigational Therapies""""EFFECTS OF REIMBURSEMENT POLICIES ON INNOVATION""""The Impact of the PPS on Clinical Research""; ""Decreasing Effective Patent Life""; ""GROWING DISINCENTIVES TO PROVIDING STATE-OF-THE-ART CARE""; ""PROSPECTS FOR THE FUTURE""; ""NOTE""; ""REFERENCES""; ""5 The Impact of Public Policy on Medical Device Innovation: A Case of Polyintervention ""; ""THE ASSESSMENT: PUBLIC POLICIES AND MEDICAL DEVICE INNOVATION""; ""The Limits of the Traditional Models of Innovation""; ""The Pivotal Role of Public Policy""; ""THE MEDICAL DEVICE INDUSTRY AS PATIENT""""THE EVALUATION: THE IMPACT OF POLYINTERVENTION""""Case Study: Lithotripsy""; ""Case Study: Intraocular Lenses""; ""TREATMENT OPTIONS: IMPROVING THE PUBLIC POLICY ENVIRONMENT""; ""Fine-tuning Individual Policies""; ""Understanding Polyintervention""; ""CONCLUSION""; ""NOTE""; ""REFERENCES""; ""6 The Dynamics of Medical Device Innovation: An Innovator's Perspective ""; ""PATENTS""; ""WHO DOES R&D?""; ""FINANCING OF INNOVATION""; ""REGULATORY DIFFERENCES""; ""THE ROLE OF LIABILITY""; ""REIMBURSEMENT""; ""CONCLUSIONS""; ""SELECTIVE BIBLIOGRAPHY""""7 Reimbursement and the Dynamics of Surgical Procedure Innovation ""Medical innovation at the crossroads ;v. 2.Medical innovationsEconomic aspectsCongressesPharmaceutical industryTechnological innovationsEconomic aspectsCongressesMedical innovationsEconomic aspectsPharmaceutical industryTechnological innovationsEconomic aspects338.43/61/028Gelijns Annetine1640409Halm Ethan A1724250Institute of Medicine (U.S.).Committee on Technological Innovation in Medicine.Howard Hughes Medical Institute.United States.Agency for Health Care Policy and Research.MiAaPQMiAaPQMiAaPQBOOK9910817058403321The Changing economics of medical technology4126199UNINA