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12:00 AM
Jul 06, 2009
 |  BioCentury  |  Politics, Policy & Law

Commentary: Seven hump Wump

If a camel is a horse that was designed by a committee, what is a comparative effectiveness policy that is being designed in great haste by two committees, a pair of federal agencies and a cabinet secretary? Perhaps it is Mr. Gump's seven hump Wump, made famous by Dr. Seuss in "One fish, two fish, red fish, blue fish."

Whatever the beast is called, it isn't likely to be an efficient vehicle for achieving the goals President Obama and senior members of his administration have set for comparative effectiveness research (CER), which is to develop the evidence needed to help "bend the curve" of increasing healthcare costs while dramatically improving the quality of care.

Two reports last week made suggestions about how to spend some of the $1.1 billion the government is preparing to invest in studies comparing the effectiveness of various medical interventions.

CER isn't the bête noir its opponents, including some in the pharmaceutical industry, have portrayed it as. Indeed, it is absurd for the leaders of a science-based endeavor like drug development to object to the collection of new information about how products work in the real world, or for them to think they can dictate how that information will be disseminated and used. Payers, including government, and physicians, will seek answers to the questions they find most relevant, and inevitably they'll apply those answers when making reimbursement, coverage and prescription decisions.

But CER will be valuable to the extent that the right questions are asked and reliable methods are used to answer them. So far, there is little reason to believe the U.S. government is going in the right direction.

A big part of the problem is that there is a rush to fund CER projects because the money has been allocated as part of the economic stimulus package.

Office of Management and Budget Director Peter Orszag has been calling unsuccessfully for a massive increase in government-funded CER for years. The economic crisis turned out to be an opportunity the Obama administration could not pass up.

CER funding was added to the American Recovery and Reinvestment Act (ARRA), a law that was intended to stimulate the U.S. economy and therefore requires that money be spent within two years. CER could do a...

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