Thoughts from ISPOR conference (D. Frame EMPH ’09)

Comparative effectiveness research was the big topic at this meeting of pharmacoeconomics and outcomes researchers (www.ispor.org). Speakers at a Tuesday plenary session included Hal Sox, Annals of Internal Medicine editor and chair of the Institute of Medicine (IOM) panel charged with prioritizing areas for the $1.1 billion comparative effectiveness research funding in the stimulus package.

In some sense people here feel that the “comparative effectiveness” moniker is just attaching another word to what many researchers have been doing all along – finding ways to see how well health care interventions work once they are translated to the “real world” of clinical practice. This is not to say the administration’s policies will not make a difference, however. This kind of research is often conducted using large observational databases rather than a priori controlled trials, so there is a perception that more gaming of the results is possible – payers can get the answers they want from their analysis, while pharmaceutical companies can get the answers they want from competing analysis, sometimes using the same data source.

The big difference that government involvement can make, then, is breaking the stalemate on comparative effectiveness research by requiring projects it funds to be truly transparent: prospective registration of plans for how the analysis will be conducted, for instance, and requirements to make findings publicly available regardless of the result. It remains to be seen what the exact parameters of these projects will be, and whether they will vary across the agencies involved (the funding is split between AHRQ, NIH, and HHS).

The IOM panel’s report on national priorities for research is due out June 30th.

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