Lessons From India in Organizational Innovation: A Tale of Two Heart Hospitals

Recent discussions in health reform circles have pinned great hopes on the prospect of innovation as the solution to the high-cost, inadequate-quality U.S. health system. But U.S. health care institutions--insurers, providers and specialists--have ceded leadership in innovation to Indian hospitals such as Care Hospital in Hyderabad and the Fortis Hospitals around New Delhi, which have U.S.-trained doctors and can perform open heart surgery for $6000 (compared to$100,000 in the United States). The Indian success is a window into America\u27s stalemate with inflating costs and stagnant innovation

The Path Forward: A Post-Omicron Strategy for the Global COVID-19 Response

At this pivotal moment, the world's response to the pandemic must shift from emergency crisis management to a sustainable control strategy. This strategy should help to build resilient health systems with capabilities to address potential future COVID-19 outbreaks and other public health threats. Driving the urgent need for an updated strategy are important recent developments related to the SARS-CoV-2 virus, the impact of current vaccines, and the world's response to the pandemic

Economic effects of prolonged clopidogrel therapy after percutaneous coronary intervention

ObjectivesThis study examined the incremental cost-effectiveness of extending clopidogrel therapy from one month to one year after percutaneous coronary intervention (PCI) in an unselected, heterogeneous patient population.BackgroundClinical trials suggest that prolonging clopidogrel therapy for up to one year after PCI reduces downstream cardiac events. However, clopidogrel therapy is costly and may increase bleeding risk.MethodsUsing decision analysis, we compared the outcomes and cost of prolonging clopidogrel treatment from one month to one year after PCI with the alternative strategy of discontinuing therapy one month after the procedure. Event rates were based on 3,976 PCI patients who were treated between January 1999 and December 2001 at the Duke Medical Center and received no more than one month of clopidogrel after the procedure. Baseline characteristics and event rates were obtained from Duke clinical information systems. The effect of prolonged clopidogrel therapy on event rates was based on the Clopidogrel for the Reduction of Events During Observation (CREDO) trial per-protocol data. Unit costs and the effect of myocardial infarction (MI) on life expectancy were based on published sources.ResultsExtending clopidogrel therapy from one month to one year after PCI cost $879 per patient and reduced the risk of MI by 2.6$15,696 per year of life saved. Economic attractiveness of therapy varied with baseline risk, the effect of prolonged therapy on MI risk, and the price of clopidogrel.ConclusionsProlonging clopidogrel therapy for one year after PCI is economically attractive, particularly in high-risk patients

The Health Innovation Impact Checklist: a tool to improve the development and reporting of impact models for global health innovations

Donor financing is increasingly relying on performance-based measures that demonstrate impact. As new technologies and interventions enter the innovation space to address global health challenges, innovators often need to model their potential impact prior to obtaining solid effectiveness data. Diverse stakeholders rely on impact modeling data to make key funding and scaling decisions. With a lack of standardized methodology to model impact and various stakeholders using different modeling strategies, we propose that a universal innovation impact checklist be used to aid in transparent and aligned modeling efforts. This article describes a new Health Innovation Impact Checklist (HIIC) – a tool developed while evaluating the impact of health innovations funded under the Saving Lives at Birth (SL@B) program. SL@B, a global health Grand Challenge initiative, funded 116 unique maternal and newborn health innovations, four of which were selected for cost-effectiveness analyses (CEAs) within our evaluation. A key data source needed to complete a CEA was the lives saved estimate. HIIC was developed to help validate draft impact models from the SL@B donors and our own team’s additional modeling efforts, to ensure the inclusion of standardized elements and to pressure test assumptions for modeling impact. This article describes the core components of HIIC including its strengths and limitations. It also serves as an open call for further reviewing and tailoring of this checklist for applicability across global efforts to model the impact of health innovations