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Science Dies Again
The U.S. House has put so many stipulations around the potential uses of comparative efficacy data, that it is--in the words of another blog--entirely "neutered."
So insurance will continue to be the ones who _do_ deny and ration care based on their own versions of comparative efficacy. So will formularies based on the usual "arrangements," some legal, some not. And science will be flushed down the toilet.
http://www.reuters.com/article/rbssHealthcareNews/idUSN3043148420090730
Showing posts with label comparative efficacy. Show all posts
Showing posts with label comparative efficacy. Show all posts
Friday, July 31, 2009
Monday, April 13, 2009
COMPARATIVE EFFICACY--BOON OR BOONDOGGLE?
The Comparative Efficacy Debate
As all here will know, the Obama administration has set aside $1.1 billion dollars for comparative efficacy guidelines. Many have expressed concerns that the results could be used by private and public insurance to deny coverage for certain treatments. Some of the most recent statements coming from administration officials are not entirely reassuring on that score.
Below excerpts from a WSJ article on the topic. It is striking that people as otherwise ideologically separated has John Kyl and Russ Feingold have tried, unsuccessfully, to pass legislation intended to prevent the CE results from impacting insurance coverage.
All of us know that comparative efficacy based on large populations may or may not be relevant to particular patients. We also know that there are already de facto comparative efficacy differentials in private insurance. Most that will pay for generic simvastatin will not pay for brand-name Lipitor, even though there are definitely patients who respond differently to the two medications (I happen to be one of them). Perhaps most relevant, the comparative efficacy plan as currently conceived will rely on existing, published studies. And that will provide even more incentive toward the cherry-picking and spinning of data, endpoints, etc. that characterize so many published studies.
That is where the boondoggle comes in........
APRIL 14, 2009
Push to Compare Treatments Worries Drug, Device Makers
By JANE ZHANG
WASHINGTON -- Federal health-care agencies are getting $1.1 billion in economic-stimulus funds for research comparing the effectiveness of various treatments. But drug and medical-device makers, along with some members of Congress, say they are worried the findings will be used to limit patients' options.....
Peter Orszag, director of the White House Office of Management and Budget, told lawmakers last month that the research won't necessarily lead to coverage denials. "At the extreme, if something is shown not to be effective, it could simply not be covered," he said. But he also suggested the government could pay "more for the things that work than the things that don't."
Dr. Clancy, an appointee of former President George W. Bush, said the Centers for Medicare and Medicaid Services, the agency that manages Medicare, already uses AHRQ research to help decide what treatments it will cover. Dr. Clancy said, however, that her agency isn't the one making regulations or insurance-payment decisions, nor does it recommend what treatments are best.....
Sen. Jon Kyl (R., Ariz.) unsuccessfully pushed a measure recently to bar federal health programs from using comparative-effectiveness research to deny coverage. His amendment got 44 votes, including those of Sens. Charles Grassley (R., Iowa) and Russ Feingold (D., Wisc.), who have played major roles in health-care legislation.....
As all here will know, the Obama administration has set aside $1.1 billion dollars for comparative efficacy guidelines. Many have expressed concerns that the results could be used by private and public insurance to deny coverage for certain treatments. Some of the most recent statements coming from administration officials are not entirely reassuring on that score.
Below excerpts from a WSJ article on the topic. It is striking that people as otherwise ideologically separated has John Kyl and Russ Feingold have tried, unsuccessfully, to pass legislation intended to prevent the CE results from impacting insurance coverage.
All of us know that comparative efficacy based on large populations may or may not be relevant to particular patients. We also know that there are already de facto comparative efficacy differentials in private insurance. Most that will pay for generic simvastatin will not pay for brand-name Lipitor, even though there are definitely patients who respond differently to the two medications (I happen to be one of them). Perhaps most relevant, the comparative efficacy plan as currently conceived will rely on existing, published studies. And that will provide even more incentive toward the cherry-picking and spinning of data, endpoints, etc. that characterize so many published studies.
That is where the boondoggle comes in........
APRIL 14, 2009
Push to Compare Treatments Worries Drug, Device Makers
By JANE ZHANG
WASHINGTON -- Federal health-care agencies are getting $1.1 billion in economic-stimulus funds for research comparing the effectiveness of various treatments. But drug and medical-device makers, along with some members of Congress, say they are worried the findings will be used to limit patients' options.....
Peter Orszag, director of the White House Office of Management and Budget, told lawmakers last month that the research won't necessarily lead to coverage denials. "At the extreme, if something is shown not to be effective, it could simply not be covered," he said. But he also suggested the government could pay "more for the things that work than the things that don't."
Dr. Clancy, an appointee of former President George W. Bush, said the Centers for Medicare and Medicaid Services, the agency that manages Medicare, already uses AHRQ research to help decide what treatments it will cover. Dr. Clancy said, however, that her agency isn't the one making regulations or insurance-payment decisions, nor does it recommend what treatments are best.....
Sen. Jon Kyl (R., Ariz.) unsuccessfully pushed a measure recently to bar federal health programs from using comparative-effectiveness research to deny coverage. His amendment got 44 votes, including those of Sens. Charles Grassley (R., Iowa) and Russ Feingold (D., Wisc.), who have played major roles in health-care legislation.....
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