title: How do medical device manufacturers' websites frame the value of health innovation? An empirical ethics analysis of five Canadian innovations.
abstract: While every health care system stakeholder would seem to be concerned with obtaining the greatest value from a given technology, there is often a disconnect in the perception of value between a technology's promoters and those responsible for the ultimate decision as to whether or not to pay for it. Adopting an empirical ethics approach, this paper examines how five Canadian medical device manufacturers, via their websites, frame the corporate "value proposition" of their innovation and seek to respond to what they consider the key expectations of their customers. Our analysis shows that the manufacturers' framing strategies combine claims that relate to valuable socio-technical goals and features such as prevention, efficiency, sense of security, real-time feedback, ease of use and flexibility, all elements that likely resonate with a large spectrum of health care system stakeholders. The websites do not describe, however, how the innovations may impact health care delivery and tend to obfuscate the decisional trade-offs these innovations represent from a health care system perspective. Such framing strategies, we argue, tend to bolster physicians' and patients' expectations and provide a large set of stakeholders with powerful rhetorical tools that may influence the health policy arena. Because these strategies are difficult to counter given the paucity of evidence and its limited use in policymaking, establishing sound collective health care priorities will require solid critiques of how certain kinds of medical devices may provide a better (i.e., more valuable) response to health care needs when compared to others.
authors.affiliation: Department of Health Administration, University of Montreal, and Institute of Public Health Research of the University of Montreal (IRSPUM), C.P. 6128, Succursale Centre-ville, Montreal, QC, H3C 3J7, Canada. pascale.lehoux@umontreal.ca
authors.forename: P
authors.initials: P
authors.lastname: Lehoux
authors.forename: M
authors.initials: M
authors.lastname: Hivon
authors.forename: B
authors.initials: B
authors.lastname: Williams-Jones
authors.forename: F A
authors.initials: FA
authors.lastname: Miller
authors.forename: D R
authors.initials: DR
authors.lastname: Urbach
mesh_terms: D001720:Birth Injuries / Q000517:prevention & control; D001943:Breast Neoplasms / Q000175:diagnosis; D002170:Canada; D003452:Cryosurgery / Q000941:ethics / Q000379:methods; D020000:Decision Support Systems, Clinical / Q000941:ethics; D004059:Diffusion of Innovation; D004864:Equipment and Supplies / Q000941:ethics*; D005260:Female; D019981:Health Care Sector / Q000941:ethics*; D006699:Home Care Services / Q000941:ethics; D006801:Humans; D020407:Internet / Q000941:ethics / Q000706:statistics & numerical data; D019060:Minimally Invasive Surgical Procedures / Q000941:ethics / Q000379:methods; D057054:Molecular Imaging / Q000941:ethics / Q000379:methods; D008991:Monitoring, Physiologic / Q000941:ethics / Q000379:methods; D019637:Orthopedic Procedures / Q000941:ethics / Q000379:methods; D012945:Social Values