International diffusion of new health technologies: a ten-country analysis of six health technologies

Claire Packer, Susan Simpson, Andrew Stevens

    Research output: Contribution to journalArticle

    44 Citations (Scopus)


    OBJECTIVES: The objective of this study was to examine and explain the differential international diffusion of six health innovations. METHODS: A retrospective diffusion study was undertaken of sildenafil, cyclooxygenase-II (COX II) inhibitors, beta interferon, verteporfin, deep brain stimulators, and drug-eluting coronary stents in ten countries-Australia, Canada, Denmark, France, The Netherlands, Norway, Spain, Sweden, Switzerland, and the United Kingdom. We plotted diffusion curves of daily defined doses per quarter, vials or implants per million population, and examined the association between diffusion and five key variables. RESULTS: Canada, Switzerland, and Sweden are generally high users of new technologies; Spain, Denmark, and particularly the United Kingdom are low users. Almost all countries experienced rapid adoption of sildenafil with diffusion to a similar level; there was variable adoption and diffusion of COX II inhibitors, verteporfin, and interferon beta; drug-eluting stents penetrated the market in a similar way in all but one country; and two countries had very different adoption patterns for deep brain stimulators. Above average health spending and the presence of health technology assessment (HTA) or other guidance reports are consistently associated with increased diffusion. Early warning activity and a national coverage decision being taken are more likely to be associated with a reduced diffusion. CONCLUSIONS: The significant differences in diffusion between different countries are not consistent with a neat evidence-based world. The tools available to policy makers to control diffusion (early warning systems, HTA, and a fourth hurdle) play some part in influencing diffusion but need close scrutiny of how successfully they operate.
    Original languageEnglish
    Pages (from-to)419-428
    Number of pages10
    JournalInternational Journal of Technology Assessment in Health Care
    Issue number4
    Publication statusPublished - 1 Oct 2006


    • health technology
    • forecasting
    • international
    • diffusion of innovation
    • technology assessment


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