Funding the Unfundable: Mechanisms for managing uncertainty in decisions on the introduction of new and innovative technologies into health care systems

Tania Stafinski, Christopher McCabe, Devidas Menon
Research Summary: 

Purpose of Study
The purpose of this project was to compile an inventory various types of Access with Evidence Development (AED) schemes, examining characteristics of the technologies to which they have been applied, the uncertainty they sought to address, the terms of arrangements of each scheme, and the policy outcomes.

Research Approach/Method
The authors performed a comprehensive search, review and appraisal of peer-reviewed and 'grey' literature, followed by a facilitated workshop of academics and decision makers with expertise in AED schemes.

Key Overarching Message
Although the concept of AED is not new, evaluative data are sparse. Despite varying opinions on the right answers to some of the questions raised, there appears to be consensus on a way forward in development of methodological guidelines.

Key Findings
All stakeholders seemed to share the view that AEDs offer the potential to facilitate patient access to promising new technologies and encourage innovation while ensuring effective use of scarce health care resources. There is no agreement on what "sufficient evidence" constitutes, and it depends on the specific uncertainty in question. There seemed to be agreement for the need for best practice guidelines around the implementation and evaluation of AED schemes.