Researching 'Comparative Effectiveness' of Treatments
Smerd, Jeremy, Workforce Management
"Currently, patients and their physicians have little, if any, Independent, reliable information comparing the efficacy of various procedures, therapies or devices." -HELEN DARUNO, president, National Business Group on Health, In a statement
TUCKED INSIDE the recently signed economic stimulus package is a line item that is much smaller than the $19 billion slated to bring doctors into the information age. But the provision could go a long way toward helping employers spend their health care dollars more wisely.
The federal government has committed $1.1 billion to compare the effectiveness of different drugs, medical devices and surgeries to treat the same illness.
This "comparative effectiveness" research could eventually help employers identify the most cost-effective and beneficial health care treatments, and then steer patients toward them. Employers could save money and improve the health of patients by paying for procedures that are considered to be of great benefit while not covering treatments that have proved to be of little value.
Without comparative effectiveness research, decisions about what treatments to use often "depend on anecdotal evidence, conjecture and the experience and judgment of the individual physicians involved," according to a policy paper published by the Congressional Budget Office in 2007.
For example: Which is the more cost-effective and better treatment for a patient suffering from acid reflux disease, one of the most common conditions affecting older Americans? Is it medicine or surgery? In 2005, the federal Agency for Healthcare Research and Quality, in its first comparative effectiveness review, said drugs can be as effective as surgery in preventing stomach acid from being regurgitated.
The agency continues to review the effectiveness of treatments for other diseases or conditions, such as the use of noninvasive procedures to detect breast cancer. In 2006, the agency reported that four types of tests - magnetic resonance imaging being one of them - were not accurate enough to replace biopsies.
"The research could lead to objective criteria that says these treatments work and these do not," says Jim Winkler, a health care consultant with Hewitt Associates.
The lack of comparative effectiveness research helps explain why the quality and cost of care varies drastically across the country, the CBO report said. …