Do economic evaluations of TAVI deal with learning effects, innovation, and context dependency? A review

Most collectively funded healthcare systems set limits to their benefit package. Doing so requires judgements which may involve economic evaluations. Performing such evaluations brings methodological challenges, be more pronounced in non-pharmaceutical interventions. For example, for medical devices, the validity of assessment results limited by learning effects, incremental innovation devices and context-dependency outcomes. To review extent "learning effects", "incremental innovation" (related outcomes) "context-dependency" are included and/or discussed peer reviewed on using Transcatheter Aortic Valve Implementation (TAVI) as an example. A systematic was performed including full TAVI operable patients with aortic stenosis identified Pubmed database. Study characteristics, study text fragments concerning aforementioned aspects were extracted. The quality studies assessed a checklist (CHEC-extended). Within 207 screened records, 15 identified. Two referred all three aspects, four none. "Learning effects" five studies, one described method cope this challenge. “Incremental innovation” seven studies. Limitations generalizability related context care provision challenges influence reported results, typically only partly rarely dealt within It is important better informed policy decisions that improves.