‘Innovation’ in health care coverage decisions: All talk and no substance?
Bibliographic record
Abstract
There has been much discussion recently about 'innovation', or more precisely the lack of it, in pharmaceuticals and devices in health care. The concern has been expressed by national guideline bodies, such as the Common Drugs Review in Canada and the National Institute for Health & Clinical Excellence in the UK, applying strict cost-effectiveness criteria in their decision-making and, therefore, failing adequately to recognize the full benefits that come from innovation. In order to explore the legitimacy of such claims, we first define innovation, and second, explore the basis for assuming an independent and separable social value associated with innovation. We conclude that demands relating to innovation, such as relaxation of thresholds and premium prices for innovatory products, remain hollow until we have a compelling case on the demand side for a separable social value on 'innovation'. We see no such case currently.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.044 | 0.132 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.004 | 0.039 |
| Scholarly communication | 0.012 | 0.029 |
| Open science | 0.002 | 0.007 |
| Research integrity | 0.017 | 0.016 |
| Insufficient payload (model declined to judge) | 0.011 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".