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Rapid Payoff from Comparative Effectiveness Research Questioned

By John Reichard, CQ HealthBeat Editor

May 19, 2014 -- A survey of major players in the health care system overwhelmingly finds that comparative effectiveness research (CER) to identify the best performing drugs, medical devices and procedures and the optimal way to organize how health care is delivered, is having little impact so far.

That might seem like a terrible piece of news given the billions of dollars the health care overhaul (PL 111-148, PL 111-152) has committed to the field. But the groups surveyed generally are optimistic that the research will eventually bear fruit.

The survey is one more piece of evidence tempering hopes for a big payoff from the field of CER in terms of "bending the curve" in health care spending growth.

The survey was conducted by Scientific & Social Systems on behalf of the National Pharmaceutical Council, a policy research organization funded by drugmakers worried that CER will be used by payers to make "one size fits all" decisions about what products and procedures to fund.

A total of 110 organizations including researchers, employers, trade groups and insurers were polled between Aug. 13, 2013 and Jan. 31, 2014.

A full 84 percent of respondents said the research had little impact on health care decision making in the prior 12 months. However, 92 percent said they expect the research to have a moderate to substantial impact on health care decision making in the next five years.

The survey also found that the research institute established by the health law, the Patient Centered Outcomes Research Institute (PCORI), is a central force in the field.

Seventy six percent of those surveyed named PCORI as the leader in setting research priorities in the field over the next five years, followed by the National Institutes of Health (66 percent), and that Agency for Healthcare Research and Quality (62 percent).

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