Washington Post Examines Comparative Effectiveness Research Funding in Economic Stimulus Package

Debate continues over the $1.1 billion in stimulus funds for comparative effectiveness research, which aims to find the best health care treatments at the lowest prices, the Washington Post reports. While proponents say such research can lead to cost savings, opponents say it could result in rationed health care, where patients are denied potentially lifesaving treatments because of cost.

The Agency for Healthcare Research and Quality will receive $300 million of the funds, while HHS and NIH will divide the remainder. Over the coming months, experts at the Institute of Medicine will prioritize the research. President Obama "has stopped short" of recommending that results of the research be used to determine health insurance coverage, the Post reports.

Carolyn Clancy, head of AHRQ, said, "We're not saying 'Do X or Y,'" but rather, "We're saying, 'Here are the facts and you should have a conversation with your doctor.'"

State Medicaid programs, the Veterans Health Administration and many private health plans have used comparative effectiveness research to help rein in costs, according to the Post. Missouri's Medicaid program, for example, has saved almost $4 million annually by switching beneficiaries from the cholesterol drug Lipitor to a generic version -- a move prompted by research from the Oregon Health and Science University's Drug Effectiveness Review Project. Missouri also uses a computer program to track beneficiaries' usage and allows them to switch to another medication if the generic version does not work. In addition, Consumer Reports -- whose publisher, Consumers Union, also uses research from the Drug Effectiveness Review Project -- on Tuesday released a "Best Drugs for Less" list. The list includes "best buys" for treating common conditions, such as depression, diabetes and migraines.

Industry Concerns
While many in the drug and medical device industries say they support scientific reviews, they are concerned about programs that link quality and cost. Billy Tauzin, president of the Pharmaceutical Research and Manufacturers of America, said, "Used incorrectly, it allows government payers to literally ban and keep medicines from patients who need them," noting that many veterans bought Medicare drug coverage because of the restrictions in the VHA plan.

Betsy McCaughey, a fellow at the Hudson Institute who serves on the board of a medical device company, wrote that the stimulus package "treats health care the way European governments do: as a cost problem instead of a growth industry," adding, "This stimulus is dangerous to your health and the economy."

Some drug and medical device companies also are concerned that the research could turn into a "system of winners and losers," which "is bound to reduce their bottom lines," the Post reports (Connolly, Washington Post, 3/17).