Comparative effectiveness research, a proposed method to cut health care spending, is sharply criticized in a new report identifying numerous negative ramifications of the policy.
The report, “Shorter Lives, Less Prosperity: The Impact of Comparative Effectiveness Research on Health and Wealth,” was written by John Vernon and Robert Goldberg of the Center for Medicine in the Public Interest (CMPI).
“Advocates of comparative effectiveness research (CER) claim it can be used to reduce healthcare spending because a large portion [of spending] pays for medical technologies that add little health or social benefit. This assumption runs counter to evidence that medical innovation is associated with lower and greater longevity [of life],” Vernon and Goldberg write.
Millions in Years, Billions in Costs
The report relies on empirical models employed to establish a direct relationship between pharmaceutical returns on investment and clinical development costs. Vernon and Goldberg then connect the cost of CER with rates of research and development (R&D).
“To the extent that CER is used to reduce the development and use of new drugs, devices, and diagnostics, it is important to estimate what impact the reduced rate of innovation would have on quality of life and life expectancy,” Vernon and Goldberg write. “We found that CER could conservatively increase R&D costs by an amount equal to 50 percent of the most complex and time consuming part of drug development. The added cost would reduce R&D spending by $32 billion over ten years.”
Based on prior research connecting life expectancy with R&D, Vernon and Goldberg conclude CER would cost Americans roughly 81 million life years and $4 trillion dollars over the same period.
CER and Rationing
Pharmaceutical expert Peter Pitts, president and cofounder of CMPI, emphasizes the public is in danger of health care being rationed through the use of CER.
“The public will not get the best possible care and at the earliest time possible,” he said. “Cutting costs in the short term costs more in the long term. It also lowers the quality of health care people can get.”
President Obama’s health care law put a significant emphasis on the possible impact of CER on health care innovation through a newly created government institute, designed to apply this comparative model across government decisions. Pitts says political leadership is needed to push for an alternative view, and create a health care system that is patient-centered, not cost-centered.
“We must encourage our political leaders to put patients and not cost saving first,” he said.
Tabassum Rahmani ([email protected]) writes from Dublin, California.
“Shorter Lives, Less Prosperity: The Impact of Comparative Effectiveness Research on Health and Wealth,” by John Vernon and Robert Goldberg: http://www.cmpi.org/uploads/File/CER_Paper_FINAL.pdf