How soon might comparative effectiveness offer significant change? And which entities will guide these changes when they begin? Inside the nation's capitol, CER has become something of a mantra among those hoping to drive down health care costs. But beyond the Beltway, CER appears not to be nearly as potent a concept, for now anyway.
To gauge the extent to which CER is perceived, the National Pharmaceutical Council, a policy and research organization supported by pharma, surveyed 111 people from federal agencies, consumer and trade groups, insurers and academics, among others. And NPC found nearly 60 percent are "very familiar” with CER, but only 30 percent believe CER will lead to moderate improvements in health care decision-making in the next year.
One reason for the lack of near-term optimism may be that the Patient-Centered Outcomes Research Institute, the non profit created by health care reform to oversee CER, is simply too new to have made an impression on many radar screens, according to NPC president Dan Leonard. "It is still very early in the implementation," he says in a statement, but insists "there is a clear recognition that the work isn’t done on CER."
"What’s unclear is whether the 70 percent of respondents who believe there will be only slight or no improvement over the next year would offer a different answer if they were asked about changes over the next three to five years or beyond," according to the NPC summary. "We believe it is a fair assumption to say that respondents are taking the long view when it comes to CER, and not immediate results."
Here are some findings: about 55 percent of survey respondents were “very familiar” with CER; 68 percent believe it will take less than three years to establish research standards for CER Studies; 85 percent felt that CER led to little or no improvement for health care decision-making in the past year; 11 percent thought it led to moderate improvements, and 30 percent believed that CER would lead to moderate improvements in health care decision-making in the next year.
Also, 78 percent believe the Agency for Healthcare Research and Quality will establish research standards and 64 percent look to the National Institutes of Health to do so, but only 13 percent think the pharmaceutical industry will have this role (we should note that respondents were permitted to cite more than one entity in answering this question).
Similarly, most believe the AHRQ and NIH will establish research priorities, although 63 percent look to PCORI to fill this function and 31 percent believe the pharmaceutical industry will do so, or at least play a larger role. When it comes to conducting research, 85 percent see academia doing most of the work, followed by 62 percent looking to the pharmaceutical industry (you can read more here).
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