Abstract

It often costs a great amount of money to develop new medical devices such as implants. In addition, the use of such devices does not always lead to cost savings. It is therefore important to obtain information on how the costs relate to the degree in which the health and/or quality-of-life of patients improve by these implants. This information can be obtained by carrying out a cost-effectiveness analysis. However, insurance companies, physicians, and organisations that determine whether an implant is eligible for insurance coverage do not pay much attention to the cost-effectiveness of implants. This was the conclusion of a study carried out by RIVM (National Institute for Public Health and the Environment).

RIVM recommends to consider information on cost-effectiveness when purchasing implants in the healthcare sector. Cost-effectiveness could also be given greater importance in other decisions as well, for example in deciding whether health insurance should cover the cost of a product. Such information could also create greater transparency regarding the factors included in deciding whether or not implants are eligible for insurance coverage. In order for medications to be covered by health insurance, manufacturers are required to carry out extensive cost-effectiveness studies. However, information on cost-effectiveness is not required for implants. In addition, it is often not clear what a (new) implant costs exactly.

For the study at hand, RIVM reviewed the scientific literature available on the cost-effectiveness of three implants: hip prostheses, the Essure sterilisation method, and pelvic floor mesh implants. The economic assessments presented in the scientific literature are not always complete and of good quality. Side-effects are underestimated or not considered. If they are taken into account, then often only the short-term side-effects are considered. This can lead to an overestimated optimistic picture of the cost-effectiveness of the implant in question.