Comparative Effectiveness Research Could Save Money, Support Providers, and Empower Patients

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<p>Yesterday in the <em>New England Journal of Medicine</em>, researchers reported that sharply reducing the use of two medical procedures about which benefit or safety questions have been raised would save hundreds of millions of dollars a year. The analysis, by Adam Elshaug, M.P.H., Ph.D., a Commonwealth Fund Harkness Fellow in Health Care Policy, and Alan Garber, M.D., Ph.D., of Stanford University, points to the potential value of federal investment in comparative effectiveness research (CER), which compares the clinical effectiveness, risks, and benefits of treatments.</p>
<p>In their <a href="/publications/journal-article/2011/apr/how-cer-could-pay-itself-insights-vertebral-fracture">"Perspective" piece</a>, Elshaug and Garber reviewed the history of two procedures intended to relieve the pain and disability associated with osteoporosis-related vertebral fractures. While many health insurers had covered these procedures—which involve injecting cement into the vertebra—based on promising early studies, more rigorous CER raised benefit and safety concerns, leading to changes in payer coverage policies.</p>
<p>Reducing the use of these procedures by 80 percent, say the authors, would save approximately $725 million annually, more than the $500 million projected annual budget of the Patient-Centered Outcomes Research Institute, the entity created by the Affordable Care Act to support CER. In other words, the government’s investment in CER would more than pay for itself.</p>
<p>In a <a href="/blog/2011/promise-comparative-effectiveness-research-empowering-patients-and-providers">related blog post</a> on, Commonwealth Fund Executive Vice President for Programs Anthony Shih, M.D., M.P.H., notes that most of the implications of comparative effectiveness research will not be clear-cut. Like the "Perspective" authors, he believes it will be rare for a CER study to demonstrate that a new treatment is never appropriate for any patient, and therefore should never be covered. </p>
<p>"The greatest value of CER may be that it can support providers in providing the best care, and empower patients to make the best personal choice when reasonable alternatives exist," Shih says. For more, read the <a href="/blog/2011/promise-comparative-effectiveness-research-empowering-patients-and-providers">complete blog post</a>. <br /></p>