Baucus: 'effectiveness' part of health-care bill, could reduce health xosts

Jun 10 2009

"Senate Finance Chairman Max Baucus, D-Mont., said Tuesday he expects Senate health-care legislation will include provisions encouraging doctors to compare drugs and therapies for their effectiveness," Dow Jones Newswires reports.

At a conference at the Brookings Institution, "Baucus said he plans to re-introduce legislation with Sen. Kent Conrad, D-N.D., that further boosts" comparative effectiveness research. The research, which "saw $1.1 billion from the federal stimulus package earlier this year," lets "doctors and patients to utilize publicly-available information on medical treatments, has emerged as something of a political lightning rod this year. Some conservative Republicans are suggesting it would result in rationing of health care." But Baucus "sought to dispel that notion Tuesday, saying that the research would not be used solely to cut costs" (Yoest, 6/9).

Kaiser Health News adds that "Baucus says lawmakers can ease critics' fears by ensuring that research is 'patient focused,' that physicians play a significant role and that decisions are based on clinical evidence about what works best, not solely on cost." The Baucus-Conrad bill from last year "would have created a public-private comparative effectiveness institute to set national research priorities and contract with government agencies and private groups to conduct the evaluations" (Appleby, 6/9).

BusinessWeek reports that "whenever researchers compare drugs or treatments to see which works best, somebody's ox gets gored. Such 'comparative effectiveness' studies have already cast doubt on expensive new blood pressure and schizophrenia drugs, as well as spinal fusions and other surgeries." The process of educating patients about the alternatives to expensive procedures "leads patients to choose conservative options more often," providing an opportunity to potentially "trim hundreds of billions of dollars from the nation's $2.4 trillion health-care bill." And patients "do as well or better than if they had opted for the procedures." But "sharing of evidence is rare" in the American health care system, and "financial incentives" for doctors and hospitals are "heavily skewed toward doing more surgeries and other procedures, not fewer." One study showed that "misconceptions" about the effectiveness of the procedures also "skew even the scientific view of the disease," which also causes doctors to opt for the procedures even when there is no evidence they will help (Carey, 6/9).