 Quote:
Originally Posted by Independent
The "stimulus" bill included money for researching most effective practices. Some people where strongly against it because it might lead to the gov't deciding not to pay for some things.
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This week's Barron's has an article on this topic, digging into some of the expected studies and identifying some of the Big Pharma and medical supply outfits whose products might be subject to some scrutiny. I found it very interesting. It caused the light bulb go on about one of the ways that the "reducing costs" part of the conundrum might be addressed - insisting that alternative treatments "compete" against one another more directly.
Marshalling Evidence for What Makes Sense in Health Care - Barrons.com Unfortunately, the full article won't be available online to non-subscribers for several weeks . It's on page 19 of the July 6 issue if you want to read it for free at the newsstand pick up a copy or take a look at the library.
Some of the potential comparisons that are under consideration by the feds (or that were otherwise mentioned in the article):
- expensive tests for staph germs at hospitals vs. best practices in cleanliness
- Prostate surgery with a $1.3 million robot vs. radiation
- exercise as an osteoporosis treatment
- off-label prescribing of antipsychotic drugs (one of Medicare's top 10 Part B expenditures)
- drugs vs. stents in heart disease treatment
- $1500/yr. drug vs. aspirin for preventing stroke re-occurrence
A few quotes: Comparative-effectiveness research has been all too rare. Companies that sponsor most research on new treatments tend to avoid study designs that would compare their product to products already marketed by rivals. The government research will try to plug holes that aren't typically addressed by industry-sponsored treatment studies...
Quote from a journal author: "The goal of randomized efficacy trials is often to prove that a treatment is superior to a placebo..."
Most industry input was predictable...The biotech industry's main trade group warned of the shortcomings of comparative-effectiveness studies..."imposing rigid practice guidelines can interfere with the ability of providers to deliver the most appropriate care for each patient."
If your really interested (wonk alert!), here's links to the week-old govt. reports the author analyzed:
Initial National Priorities for Comparative Effectiveness Research
Initial National Priorities for Comparative Effectiveness Research - Institute of Medicine
Report to the President and the Congress on Comparative Effectiveness Research
http://www.hhs.gov/recovery/programs...rannualrpt.pdf
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