International Journal of Technology Assessment in Health Care


(Stains, Coronary Stents, and MRI in England)

Nina Booth-Clibborn a1 1 , Claire Packer a1 and Andrew Stevens a1
a1 University of Birmingham


Objective: To analyze the rates and influences on the adoption of three selected health technologies: statins, coronary stents, and magnetic resonance imaging (MRI).Methods:A retrospective diffusion study using primary care prescribing data and questionnaire responses from acute hospital trusts in the West Midlands region (population 5.3 million or 10% of England).

Results: The selected technologies had markedly different diffusion curves. Statins diffused rapidly soon after launch. Coronary stents were initially used 6 years after first availability, but within 2 years all responding hospitals reported using them. MRI scanners were initially purchased 6 years after first availability with a subsequently slow rate of diffusion, and are still absent from some hospitals. Influences on the adoption of each technology were different. Commercial marketing was reported as a major influence on the diffusion of statins but not at all on MRIs. Cost impact was a major negative influence on the diffusion of MRI scanners and statins, whereas enthusiastic individuals were key to the diffusion of stents.

Conclusions: Influences on adoption and consequent diffusion rates are very different for different health technologies. It is not at all clear that such diffusion patterns relate well to an optimum timing rate. This has important implications for technology gatekeepers in health care.

Key Words: Medical technology; Diffusion; Anticholesteremic agents; Stents; Magnetic resonance imaging.


1 Thanks to Professor Steve Chapman, Department of Medicines Management, University of Keele, for access to PACT data.This study was carried out as part of the research activity at the National Horizon Scanning Centre, which is funded by the NHS Executive.