Cost-effectiveness analysis at the development phase of a potential health technology: examples based on tissue engineering of bladder and urethra.
OBJECTIVE
We demonstrate the use of health economics to guide investment decisions in regenerative medicine. Our examples are based on proposed tissue engineering applications in the urinary tract. We show that health economics have a role in strengthening the supply side, not just the demand side of the health economy.


METHODS
We reviewed the epidemiology and treatment of the clinical conditions where TE of urothelium may be considered using literature identified from a range of sources including electronic databases, article bibliographies and references, online articles and expert opinion in the field.


RESULTS
Careful analysis of current best treatment suggested that urethral defects and bladder resection for cancer offered the most propitious applications of TE. The headroom for engineered urethral tissue was estimated at pound sterling186. This is unlikely to be large enough to support the launch of a TE product populated with viable cells. The headroom for TE bladder, on the other hand, was estimated at around pound sterling16 268. However, the market size is limited reducing potential profitability.


CONCLUSIONS
The Headroom Method can help inform instrumental decisions concerning new treatments without having to build a complex model with very wide parameter uncertainty.
Department of Public Health and Epidemiology, Public Health Building, University of Birmingham, UK.
Helen
H
McAteer
Emma
E
Cosh
Guy
G
Freeman
Anand
A
Pandit
Peter
P
Wood
Richard
R
Lilford
D020811:Biomedical Technology / Q000191:economics* / Q000706:statistics & numerical data / Q000639:trends*; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D006801:Humans; D044968:Regenerative Medicine; D023822:Tissue Engineering / Q000379:methods*; D016896:Treatment Outcome; D014521:Urethra / Q000002:abnormalities / Q000166:cytology* / Q000601:surgery; D001743:Urinary Bladder / Q000166:cytology* / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000628:therapy; D019459:Urothelium / Q000166:cytology / Q000637:transplantation