MANAGING THE DIFFUSION OF AN INNOVATING H EALTH-CARE TECHNIQUE - THE CASE OF POLYVALENT INTRAVENOUS IMMUNOGLOBULINS AT THE UNIVERSITY HOSPITALS OF PARIS

Managing new innovations in medicine is a particularly timely subject, There is an abundant history concerning over expectations resulting f rom the development of new treatments or diagnostic procedures, some s hown to be less effective than promised, others even found to be dange rous, A new aspect to the question is the importance of economic press ures which require rational investment decisions when diffusing innova ting technologies. In 1991, the Commission for the evaluation and diff usion of innovating technologies (CEDIT) at the University Hospitals o f Paris (Assistance Publique-Hopitaux de Paris) developed a programme aimed at better managing the distribution and use of polyvalent intrav enous immunoglobulins (IgIV), a new promising therapeutic tool with bo th a high cost and a certain number of risks, The programme was design ed to assist prescribers in elaborating better therapeutic strategies and to help hospital managers rationalize expenditures for IgIV. The r esults of this experience are presented here together with certain con clusions concerning the way management decisions can be applied to the diffusion of an innovation in health care.