UTFacultiesBMSDept TPSHTSRResearchTechnology Assessment for Health Systems Engineering

Technology Assessment for Health Systems Engineering

Erik Koffijberg; Associate Professor

We assess and optimize the impact of health care innovations, during and after development, on health outcomes and on the healthcare system

Erik Koffijberg; Associate Professor

What we do

Our goal is to optimize the value of new technologies and innovations in healthcare to society. We assess the impact of innovations during and after development, and from different perspectives (for example, developer, hospital, insurer, societal). Furthermore, we engineer health systems of the future by identifying how healthcare service provision will change – or needs to change – to maximize the value of healthcare innovations in a sustainable way. Our focus is the evaluation and optimization of diagnostic technologies, including biomarkers, imaging, prediction models and medical devices, in the fields of cardiology, neurology, and oncology.

In early design stages, we perform early assessments to guide further product development, for example based on expert elicitation, stakeholder analysis, headroom analysis, end user interviews, and early modelling. Following development, we support trial based and model based generation of evidence on health outcomes, healthcare costs and resource use, as well as on budget and system level impact. We use patient-level simulation models to accurately reflect clinical practice, and to develop innovative methods for optimizing the application and timing of personalized care and precision medicine interventions.

The results of our analyses support business models, reimbursement decisions, healthcare policymaking, and adoption of new technologies.



    The TANGO project aims at expanding molecular profiling of tumours to improve immune- and targeted treatment selection in patients with advanced melanoma or non-small cell lung cancer (NSCLC). TANGO includes cost-effectiveness and budget impact analysis of whole genome sequencing (WGS) to facilitate responsible introduction. Our focus is on providing insight in the consequences of implementation of WGS in the Netherlands from a health systems perspective to support health services planning. Large scale facilities, which are required for WGS, can have a major impact on health outcomes and costs of clinical oncology services. Given the complexity of healthcare delivery systems, we use dynamic simulation models to analyse the various aspects (e.g. organizational, economic, and policy) that play a role in the nationwide implementation of WGS.

  • Adoption and impact of point-of-care testing

    Although a large set of point-of-care tests is currently available, only few are used in current clinical practice. Therefore, we aim to get insight in factors that affect the implementation and use of these point-of-care tests, by means of interviews with stakeholders, multi-criteria decision analysis, and health economic modeling. In turn, this will likely contribute to efficient implementation of cost-effective point-of-care tests. Finally, we will assess the consequences of increased uptake of point-of-care tests, for example, by general practitioners from a health system level perspective.

  • B3Care

    The B3Care project aims to advance the technology readiness level of simultaneous, integrated assessment of early imaging biomarkers of lung cancer, chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) using low-dose computed tomography (CT). This so-called Big-3 (B3), combination screening is expected to have major advantages due to shared risk factors, B3 interdependence and health economic yield compared to single disease screening. Our focus is on evaluating the long-term health and economic potential of combined screening to support decision-making. A screening program aimed at high-risk individuals for three different diseases proves to be a complex system of multiple dependent factors. To capture this complexity, we use simulation models to estimate the long-term health and economic outcomes of society with different screening strategies versus no screening. More information about this project is available on b3care.nl


    The UCAN CAN-DU project aims to provide the correct treatment to patients with childhood arthritis at the opportune time. While advanced biologic therapies are frequently used and can be highly effective, we are currently unable to accurately predict which children should start biologic therapies and which can discontinue treatment without having disease flares. The overarching goal of the UCAN CAN-DU project is to integrate such innovative precision medicine strategies into practice. All pediatric rheumatology care providers across Canada and the Netherlands participate in this project. We develop simulation models to evaluate the long-term health and economic impact of biologic treatment strategies. Integrating preferences of patients, parents and clinicians into decision-making further enhances the usability and impact of the results in clinical practice. More information about this project is available on www.ucancandu.com.

Technology Developer, Health Care Organisation, Med Tech Company?
Want to know how new technology and interventions impact health outcomes, care pathways, healthcare delivery, and costs, and how this impact can be maximized?
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Featured publications

van de Ven M, Simons MJHG, Koffijberg H, Joore MA, IJzerman MJ, Retèl VP, van Harten WH. Whole genome sequencing in oncology: using scenario drafting to explore future developments. BMC Cancer. 2021 May 1;21(1):488. doi: 10.1186/s12885-021-08214-8. PMID: 33933021; PMCID: PMC8088550.

van Delft F, Muller M, Langerak R, Koffijberg H, Retèl V, van den Broek D, IJzerman M. Modeling Diagnostic Strategies to Manage Toxic Adverse Events following Cancer Immunotherapy. Med Decis Making. 2021 Apr 5:272989X211002756. doi: 10.1177/0272989X211002756. PMID: 33813943.

Koffijberg H, Degeling K, IJzerman MJ, Coupé VMH, Greuter MJE. Using Metamodeling to Identify the Optimal Strategy for Colorectal Cancer Screening. Value Health. 2021 Feb;24(2):206-215. doi: 10.1016/j.jval.2020.08.2099. Epub 2020 Oct 27. PMID: 33518027.

Kip MMA, Oonk MLJ, Levin MD, Schop A, Bindels PJE, Kusters R, Koffijberg H. Preventing overuse of laboratory diagnostics: a case study into diagnosing anaemia in Dutch general practice. BMC Med Inform Decis Mak. 2020 Jul 31;20(1):178. doi: 10.1186/s12911-020-01198-8. PMID: 32736551; PMCID: PMC7395377.

Kip MMA, IJzerman MJ, Henriksson M, Merlin T, Weinstein MC, Phelps CE, Kusters R, Koffijberg H. Toward Alignment in the Reporting of Economic Evaluations of Diagnostic Tests and Biomarkers: The AGREEDT Checklist. Med Decis Making. 2018 Oct;38(7):778-788. doi: 10.1177/0272989X18797590. PMID: 30248275; PMCID: PMC6454580.

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