Analysis: House research bill unveiled

WASHINGTON, May 15 (UPI) -- House lawmakers Tuesday unveiled a $3 billion bipartisan plan to fund medical comparative effectiveness research.

A bill co-sponsored by Reps. Tom Allen, D-Maine, and Jo Ann Emerson, R-Mo., would give the federal Agency for Healthcare Research and Quality additional funding to compare the effectiveness and cost of the treatments available for a particular condition.

Funding for the program would come from the largest U.S. healthcare payers: the federal government, insurers and employers. The results of the research would be made publicly available for payers, healthcare providers and anyone else to use.

"Television and glossy magazine ads drive demand for the latest, not necessarily the most effective, treatments," Allen said. Comparative effectiveness research "would allow doctors and other providers to make informed decisions about whether new or high-priced drugs, devices and other medical treatments do or do not provide better clinical outcomes."

"No one knows what works better or best," Rep. Emerson said. "This bill is intended to replace that false confidence with verifiable information."

Research completed during the drug and medical device approval process simply compares a treatment to no treatment to look for a positive effect. Comparative effectiveness research pits treatments against each other to see which works best for the best price.

Many other industrialized countries, like the United Kingdom and Australia, already have bodies dedicated to such research as a way to contain costs in their national healthcare systems. Though most agree their research creates valuable information, critics say it can delay the availability of important new treatments.

Without solid comparative-effectiveness data, payers, doctors and patients are in the dark about which treatments are best, supporters of the bill say.

"What's a consumer to do?" said William Vaughan, senior policy analyst at the Consumer's Union, the non-profit publisher of Consumer Reports, a magazine that does research comparing everything from toasters to automobiles.

Advertising makes it sound like treatments are "all made in Lake Wobegon where they are all said to be above average," Vaughan said.

Many payers have said they would be happy to pay their share for research that will save money in the long run.

"We're already paying a lot for things that don't work right," said Steven Wojcik, vice president of public policy at the National Business Group on Health, a coalition of large employers.

With research "we can stop using what's not working and paying for it," he told United Press International.

One group of stakeholders conspicuously absent from the funding scheme is pharmaceutical and medical device manufacturers.

That exclusion is to make sure that manufacturers, who "have a stake in the outcomes," will not be able to influence the research body, Allen said.

Drug makers, however, say they are in favor of more comparative information if it is used properly.

"It's something we very much embrace as a part of good healthcare," said Randy Burkholder, spokesman for the Pharmaceutical Research and Manufacturers of America.

"When it's done well it will demonstrate the high value of pharmaceuticals to patients and society," Burkholder told UPI.

The Allen bill does not specify how the research will be used, he said. That means payers could use information about cost -- not necessarily quality -- to deny patients treatments.

Rules need to be in place, he said, to make sure that group-level data does not keep individual patients from getting the care that works best for them. In an age where genomics are making care ever more personalized, that is especially important.

"Patients and physicians need a strong role in the process so that we end up with a patient-centered program, not a cost-centered program," Burkholder said.

But Allen said the research will be focused mainly on effectiveness, not cost.

As a result of new information about comparative usefulness and cost, "there are conclusions that payers, providers and patients might be making," he told UPI, but the point is to make care better for patients, not more limited.