The $1.1 billion earmarked for comparative effectiveness research remained in the bill that President Obama will sign. The House conferees also insisted on keeping the phrase "comparative effectiveness" throughout the authorizing language, removing the Senate's insertion of the word "clinical." The report language did note its removal was "without prejudice."
However, the conferees do not intend for the comparative effectiveness research funding included in the conference agreement to be used to mandate coverage, reimbursement, or other policies for any public or private payer. The funding in the conference agreement shall be used to conduct or support research to evaluate and compare the clinical outcomes, effectiveness, risk, and benefits of two or more medical treatments and services that address a particular medical condition.
We saw a perfect example last week of how comparative cost-effectiveness analysis can be coupled with comparative clinical-effectiveness analysis to provide useful guidance to health practitioners, patients and payers faced with a confusing array of alternatives in one particularly crowded area of health care: colon cancer screening. CMS made a preliminary decision not to pay for virtual colonoscopy.
http://www.nytimes.com/2009/02/13/he...noscopy&st=cse
CMS concluded, based on a comparative cost- and clinical-effectiveness analysis conducted by AHRQ, that taking its costs into account, virtually colonoscopy made no sense either medically or economically. Not all comparisons merit a cost-effectiveness analysis. When one drug, device, surgery or other medical technology is clearly superior to another, then the U.S. health care system, which operates without cost controls, pays for it. This legislation reinforces that approach.
Yet as anyone with even a passing familiarity with the medical science and medical economics literature understands, comparisons are rarely black and white. Most medical technologies only help a fraction of patients. Most medical technologies have some risks associated with their use. Comparative cost-effectiveness analysis is an important tool for accurately evaluating those benefits and risks.
Source: GoozNews
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