Quick, what's at the top of the list for comparative-effectiveness research? Right, those expensive biologic anti-inflammatory meds, namely Enbrel (Amgen and Wyeth), Remicade and Simponi (Johnson & Johnson and Schering-Plough) and Humira (Abbott Laboratories). According to a new priority list from the Institute of Medicine, the government should use some of that $1.1 billion earmarked for effectiveness research to study these meds and their alternatives. Not only comparing them to non-biologic alternatives, but slicing and dicing population groups to determine which work best in older folks, men, women, and certain ethnicities.
Other ideas: Surgical treatments for atrial fibrillation versus prescription meds. The full spectrum of ADHD therapies, including cognitive behavioral therapy, parental training, biofeedback, and yes, prescription meds. Dementia treatments as well, drug and non-drug approaches included. Also included are MRSA-battling techniques, such as screening, cleaning and other prevention methods, and treatments.
And those are just a few. The IOM has released a seven-page list, helpfully divided into quartiles and shaded blocks for easier perusal.
As you know, the National Institutes of Health issued its own priority list for comparative effectiveness research some time back. It, too, recommended studying biologics for autoimmune disorders, atrial fibrillation treatments, and many more. Next challenge: Designing studies that effectively compare effectiveness.
Then there's the whole issue about how to use the data, once it's acquired. Some--including our HHS Secretary Kathleen Sebelius-- advocate using cost-effectiveness data to guide Medicare coverage. Others argue that C.E. research will just lead to rationing of care. And drugmakers have said that they're all for comparing effectiveness--if cost isn't part of that comparison. What do you think? Let us know.