Session Summary: Can We Learn What Works Best In Health Care?
November 10, 2012 09:31 AM
The Politics of Comparative Effectiveness Research
During the “Can We Learn What Works Best In Health Care? The Politics of Comparative Effectiveness Research” Symposium at the APPAM 2012 Fall Research Conference, the panelists focused on the usefulness of comparative effectiveness research (CER) in controlling health care costs and making health care more effective. As there are multiple ways of treating a disease, it is seldom that the treatment can or should be the same for everyone; the United States system sees the reimbursement of costs driving practice. Currently, the U.S. spends 18% of its Gross Domestic Product on health care, but still falls far behind other developed countries in the overall health of the nation. The drivers of CER are not only financial; there is a desire to discover more about the evidence gap that exist in the health care sector. The panelists discussed who should pay for this research, how the funding structure for the research changed, and how it should be directed to take advantage of the Patient Protection and Affordable Care Act.
The audience asked questions about the role of observational methods, altering the patient and physician relationship, concern for patient outcome, and cost effectiveness analysis. Each of the participants agreed that the U.S. could spend health care funds more efficiently and be patient centered. Discussants also explored political implications of using CER in a health care setting, including the research community’s ability to bring objective information to bear on important decisions. Sherry Glied of Columbia University and formerly of the Center for Medicare and Medicaid Services, spoke about the need for more implementable recommendations, which is supported by iron-clad research. Each panelist stated the many problems that make CER controversial, including the ambiguity of research design and cognitive biases. Joe Selby, from Patient-Centered Outcomes Research Institute, discussed how the research organization has centered CER on outcome-based measurement involving the patient and physician, in order to draw out the best and most meaningful results in research questions.
Contributed by Katherine Centore, Rutgers University