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Medical innovation is perhaps the most important driver of health care spending and quality. Economists have studied pharmaceutical innovation for decades, and their findings have contributed to the debate about optimal Food and Drug Administration policy. Despite their importance to health care spending and value, there is no similar literature to inform an optimal regulation system for novel and valuable medical procedures. In this paper, we begin to fill this gap by documenting the incentives for developing medical procedures and the process through which they are approved for use. Drawing on the work of Sam Peltzman and George Stigler, we argue that the largely ad hoc system of rewards and review for medical procedures may explain the slow pace of innovation, particularly when compared with drug innovation.

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