TY - JOUR ID - 3372 TI - The Bright Elusive Butterfly of Value in Health Technology Development; Comment on “Providing Value to New Health Technology: The Early Contribution of Entrepreneurs, Investors, and Regulatory Agencies” JO - International Journal of Health Policy and Management JA - IJHPM LA - en SN - AU - Greenhalgh, Trisha AU - Fahy, Nick AU - Shaw, Sara AD - Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK Y1 - 2018 PY - 2018 VL - 7 IS - 1 SP - 81 EP - 85 KW - Innovation Policy KW - Health Policy KW - Health Technology Assessment KW - Technology-Based Ventures KW - Health Research Systems DO - 10.15171/ijhpm.2017.65 N2 - The current system of health technology development is characterised by multiple misalignments. The “supply” side (innovation policy-makers, entrepreneurs, investors) and the “demand” side (health policy-makers, regulators, health technology assessment, purchasers) operate under different – and conflicting – logics. The system is less a “pathway” than an unstable ecosystem of multiple interacting sub-systems. “Value” means different things to each of the numerous actors involved. Supply-side dynamics are built on fictions; regulatory checks and balances are designed to assure quality, safety and efficacy, not to ensure that technologies entering the market are either desirable or cost-effective. Assessment of comparative and cost-effectiveness usually comes too late in the process to shape an innovation’s development.   We offer no simple solutions to these problems, but in the spirit of commencing a much-needed public debate, we suggest some tentative ways forward. First, universities and public research funders should play a more proactive role in shaping the system. Second, the role of industry in forging long-term strategic partnerships for public benefit should be acknowledged (though not uncritically). Third, models of “responsible innovation” and public input to research priority-setting should be explored. Finally, the evidence base on how best to govern inter-sectoral health research partnerships should be developed and applied. UR - https://www.ijhpm.com/article_3372.html L1 - https://www.ijhpm.com/article_3372_ccb4fbb81d08d24206fba5ba74219427.pdf ER -