Will Comparing Drugs Destroy America?

More

Some conservatives might be shouting from the rooftops that federal funding for comparative effectiveness research on drugs, medical devices, surgeries, etc., will lead our nation inexorably toward government rationing of health care. One pharmaceutical executive I recently spoke with says he just doesn't see it.

The economic stimulus bill signed into law by President Obama earlier this year provides $1.1 billion for scientific research on the comparative effectiveness of medical treatments. The idea behind it is to develop a better body of knowledge about whether, say, one cholesterol medicine works better than another one in a certain type of patient.

To critics, though, it conjures up a nightmare scenario in which Uncle Sam uses the results of this research to decree that we can only take the drug that "wins" in the study and/or is less expensive. Countries with nationalized health care systems, such as the U.K., have government agencies that make these kinds of decisions (though it's not nearly as simple as that).

AstraZeneca CEO David Brennan was in Washington last Friday and met with reporters for an hour-long discussion that touched on a lot of issues but, given that I'd written about this comparative effectiveness controversy before, I asked him what he thought about those dire pronouncements of what it could mean for our health care system.

Here's what Brennan said:

It's not obvious to me yet that that's a particular kind of an issue. I think it is a concern that it should be looked at. I mean, I think as a principle, certainly I would say that everything that can be done to encourage patient-physician interaction should be part of how this is looked at. ... I don't know exactly what the bill does that causes people to say that, other than it's providing funding to a bunch of places to come up with reports, to consider running some trials, et cetera.

Now, the pharmaceutical industry and other medical industries lobbied pretty hard to make sure that the word "cost" didn't appear anywhere near the words "comparative effectiveness" in the stimulus bill. Their campaign contributed, at least indirectly, to how ugly the discussion about this fairly wonky subject became.

Nevertheless, Brennan could have gone an entirely different direction with his answers but instead focused on the potential benefits. "It is an opportunity to bring into the clinical-decision process more evidence," he said. "I think comparative effectiveness has an opportunity to let us treat people better."

Brennan did raise concerns about using the research to make broad "population-based" decisions about coverage rather than simply providing the information to doctors and patients. "If comparative effectiveness research becomes code for cost comparison, then we've missed an opportunity to really demonstrate, from an evidence perspective, better ways to treat individual patients that actually create value in the system," he said. He also argued against the Food and Drug Administration including cost consideration in new drug approvals but said, in the context of national health reform, "It's very difficult for me to envision that we're going to have this discussion and cost isn't going to be part of it."

UPDATE: Meanwhile, it looks like the acting director of the National Institutes of Health just gave critics of comparative effectiveness research more cause for concern.

Jeffrey Young is a staff writer at The Hill.

Jump to comments
Presented by

Jeffrey Young

Jeffrey Young is a staff writer at The Hill, the newspaper for and about Congress, where he covers health care, lobbying, politics, and the intersection thereof for the "Business & Lobbying" section. He's been covering health policy in Washington for a decade and still hasn't heard that one good idea that will fix everything. Email Jeffrey at jeffrey.young.atlanticbusiness@gmail.com
Get Today's Top Stories in Your Inbox (preview)

What's the Number One Thing We Could Do to Improve City Life?

A group of journalists, professors, and non-profit leaders predict the future of livable, walkable cities


Elsewhere on the web

Join the Discussion

After you comment, click Post. If you’re not already logged in you will be asked to log in or register. blog comments powered by Disqus

Video

Adventures in Legal Weed

Colorado is now well into its first year as the first state to legalize recreational marijuana. How's it going? James Hamblin visits Aspen.

Video

What Makes a Story Great?

The storytellers behind House of CardsandThis American Life reflect on the creative process.

Video

Tracing Sriracha's Origin to Thailand

Ever wonder how the wildly popular hot sauce got its name? It all started in Si Racha.

Video

Where Confiscated Wildlife Ends Up

A government facility outside of Denver houses more than a million products of the illegal wildlife trade, from tigers and bears to bald eagles.

Video

Is Wine Healthy?

James Hamblin prepares to impress his date with knowledge about the health benefits of wine.

Video

The World's Largest Balloon Festival

Nine days, more than 700 balloons, and a whole lot of hot air

Writers

Up
Down

More in Business

Just In