The $1.1 Billion Comparative Effectiveness Program Debate Begins

[steven johnson]

A little noticed part of the federal economic stimulus bill created a comparative effectiveness evaluation program for medical treatments. It is comparable to a British council that effectively rations healthcare services. This will pit interest groups against each other.

The administration plans to spend $1.1 billion over the next few years on studies like the one conducted by Dr. Deyo, to compare the effectiveness of competing treatments for common conditions like back pain, heart disease and prostate cancer. The studies will be publicly released, to help doctors and patients decide which treatment options they want to pursue.

The New England Journal of Medicine published several articles Wednesday supporting the federal effort and rebutting arguments raised by critics.

Whether cost should be a factor in this country was a hot-button issue during the Congressional debate in February, when the comparative-effectiveness funding was approved as part of the economic stimulus package. A legislative report by Congressional lawmakers who negotiated the final version of the bill said that they did not intend the research money to be used to "mandate coverage, reimbursement or other policies for any public or private payer."


Under the comparative effectiveness program, the Department of Health and Human Services and two agencies under it -the National Institutes of Health and the Agency for Healthcare Research and Quality - will finance studies that will look at various treatments and will pay for the development of information-gathering tools, like databases of patients being treated for a certain condition.

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