Debate Surrounds The Merits Of Comparative Effectiveness Research

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NPR reports that "The Obama administration and Congress are moving forward with plans to evaluate the strengths and weaknesses of the various medical treatments for common health conditions, despite concerns of some lawmakers and the drug and device industry that it will lead to rationed health care. But how the government uses this comparative effectiveness research and how it might benefit - or complicate - the decision-making of average people and their doctors are also matters of some debate."

NPR looks at how comparativeness effectiveness research will affect individuals like Jay Allen, who has a cardiac condition called atrial fibrillation. NPR examines the thoughts of cardiologist Stuart Seides as well as Carolyn Clancy, the head of the Agency for Healthcare Research and Quality. Clancy's agency looks at the risks and benefits and not the comparative costs of treatment. NPR reports: "[Clancy] says the studies won't get done if left up to the drug and medical device makers - discovering that their approach doesn't work as well as another one wouldn't be in their best interest. She says comparative effectiveness should be respected the same way biomedical research is, because it helps doctors determine the best approach for their patients. Clancy says determining which treatments are the most effective for specific conditions will cut the nation's health spending, because some of the choices currently made by doctors and patients - some of them quite expensive - aren't necessarily the best ones" (Silberner, 7/21).

In another piece, NPR reports on the billions of dollars Obama and Congress are already directing to comparative effectiveness research: "The findings help policymakers decide which treatments are most effective for each health care dollar spent. Yet as Congress struggles to craft a health care overhaul plan that will cut costs, lawmakers on both sides of the aisle are balking at using comparative effectiveness to limit coverage or reimbursements. Senate Republican Leader Mitch McConnell says he has no problem with the research. But he does have a problem with using its findings to restrict health care options."

NPR notes: "There is no American government entity dedicated to deciding which treatments patients can get. But there is one in the United Kingdom: the National Institute for Health and Clinical Excellence, or NICE. As the Senate health committee recently crafted its version of a health care overhaul, New Hampshire Republican Judd Gregg railed against what NICE does. Other legislators such as New Jersey House Democrat Rob Andrews as well as Democratic Senators Christopher Dodd of Connecticut and Barbara Mikulski of Maryland have also weighed in on the debate.

Meanwhile, NPR reports that Sean Tunis, former chief medical officer at the Centers for Medicare and Medicaid during the recent Bush administration, called the plans rationing. He also "says comparative effectiveness research can be a useful tool, but the problem has always been how to use its findings without igniting a political firestorm" (Welna, 7/21).

Meanwhile, the San Diego Business Journal also reports on comparative effectiveness: "A new research initiative included in the economic stimulus package, signed into law in February, aims to produce the kind of information many doctors lack today. ... Of the $787 billion American Recovery and Reinvestment Act, $1.1 billion will be dedicated to the so-called comparative effectiveness research, or studies that draw conclusions about the effectiveness of one drug, procedure or medical technique over another. ... Consumer advocacy groups, labor unions and large employers have put their support behind the new initiative, saying it could serve to fill gaps in the kind of evidence that exists today" (Chambers, 7/20).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.

© Henry J. Kaiser Family Foundation. All rights reserved.

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