title: Breaking up is hard to do: the economic impact of provisional funding contingent upon evidence development.
abstract: Funding contingent upon evidence development (FED) has recently been the subject of some considerable debate in the literature but relatively little has been made of its economic impact. We argue that FED has the potential to shorten the lag between innovation and access but may also (i) crowd-out more valuable interventions in situations in which there is a fixed dedicated budget; or (ii) lead to a de facto increase in the funding threshold and increased expenditure growth in situations in which the programme budget is open-ended. Although FED would typically entail periodic review of provisional or interim listings, it may prove difficult to withdraw funding even at cost/QALY ratios well in excess of current listing thresholds. Further consideration of the design and implementation of FED processes is therefore required to ensure that its introduction yields net benefits over existing processes.
authors.affiliation: Centre for Health Economics, Monash University, Australia. duncan.mortimer@buseco.monash.edu.au
authors.forename: Duncan
authors.initials: D
authors.lastname: Mortimer
authors.forename: Jing Jing
authors.initials: JJ
authors.lastname: Li
authors.forename: Jennifer
authors.initials: J
authors.lastname: Watts
authors.forename: Anthony
authors.initials: A
authors.lastname: Harris
mesh_terms: D004864:Equipment and Supplies; D019317:Evidence-Based Medicine; D005380:Financing, Government / Q000458:organization & administration*; D006297:Health Services Accessibility; D004364:Pharmaceutical Preparations; D057766:Policy; D012106:Research / Q000191:economics*
chemical_list: D004364:Pharmaceutical Preparations