Comparative effectiveness research may save money, but remains controversial

Comparative effectiveness research could change how certain procedures are paid for and it may be a better solution than some current cost-saving policies. The Louisville Courier-Journal reports: "Democrats' plans for health care reform would try to provide answers with more studies on which drugs, medical devices and procedures work best for different patients. But while the goal of more 'comparative effectiveness' research may sound simple, getting there may be a challenge."

The Courier-Journal reports: "Some lawmakers and pharmaceutical companies fear the research would lead to rationing of care, with government -- not doctors -- deciding which life-saving treatments patients get. They worry that treatment decisions would be made based on what's cost effective, or that services would be delivered in cookie-cutter ways that ignore differences among patients. ... Medical groups, consumer groups and insurers that support the government-funded research say it would simply help doctors provide better, higher-value care. ... Comparative-effectiveness research also could stop spending on ineffective treatments. Some supporters say that might help explain certain companies' concerns about the studies" (Gaudiano, 9/13).

Meanwhile, The New York Times reports on a case of a questionable cost-saving policy regarding kidney transplants that reform may address: "The story of Ms. Whitaker's two organ donations — the first from her mother and the second from her boyfriend — sheds light on a Medicare policy that is widely regarded as pound-foolish. Although the government regularly pays $100,000 or more for kidney transplants, it stops paying for anti-rejection drugs after only 36 months."

"The health care bill moving through the House of Representatives includes a little-noticed provision that would reverse the policy, but it is not clear whether the Senate will follow suit. The 36-month limit is one of several reimbursement anomalies — along with inadequate primary care payments and incentives that encourage unneeded care — that many in Congress hope to cure" (Sack, 9/13).

---

This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.