BMJ  2004;329:E319 (11 September), doi:10.1136/bmj.329.7466.E319

BMJ USA: Letter

Letter

RAPID RESPONSES FROM BMJ.COM

Following is an edited excerpt from one of the Rapid Responses generated by this editorial, all of which can be read in their entirety at http://bmj.bmjjournals.com/cgi/eletters/329/7456/3.—Editor

In their editorial, Dent et al call for greater efforts in evaluation of interventional procedures. Resources needed to do these evaluations are, however, difficult to find. The transnational drug industry has resources much greater than the fragmented medical device industry. More stringent requirements before devices can be sold will diminish innovations necessary for better treatments. Public money is therefore needed to improve our knowledge of the benefits and risks of interventional procedures, especially innovative procedures in surgery, which often do not require new devices from industry.

While hoping for public money for evaluating interventional procedures, we must find ways to make coherent decisions concerning new promising interventional procedures with insufficient evidence on effectiveness and safety. Claxton et al have proposed an economic model showing that the amount and type of evidence required to support the adoption of a health technology will differ substantially between technologies with different characteristics.¹ This type of framework may help in setting priorities for investing public resources for evaluating interventional procedures.

Montreal, Canada

References

1. Claxton K, Sculpher M, Drummond M. A rational framework for decision making by the National Institute For Clinical Excellence (NICE). Lancet 2002;360: 711-715.[CrossRef][ISI][Medline]

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