Tuesday, July 7, 2009

Taking Comparative Effectiveness Research from "Buzz-Phrase" to Practice

by Susan Semeleer, Associate Director, FasterCures
The Institute of Medicine (IOM) recently released a report outlining its recommendations for 100 health topics that should get priority focus and funding from a $1.1 billion effort to improve the quality and efficiency of our nation’s healthcare system. At the behest of Congress, IOM conducted a study on comparative effectiveness research to provide independent guidance on how to spend $400 million to compare best practices in healthcare delivery.

Comparative effectiveness research (CER) means exactly what its name implies: it analyzes and quantifies the benefits and harms of medical treatments. It is a crucial part of the research landscape, for doctors, for patients and their caregivers, helping to build the evidence base with which to make better informed point of care decisions.

Our primary mission at FasterCures is to identify ways to accelerate the discovery and development of new therapies for the treatment of deadly and debilitating diseases. But the mission does not – cannot – stop there. The fact is, medicine is not a one-size-fits-all proposition. What works for me may make someone else violently ill; what cures you could cripple me. This is where comparative effectiveness research becomes paramount.

As we had noted in comments to the Federal Coordinating Council for CER, we hope and expect that the vision driving federal spending and prioritization on CER will continue to be enhancing and customizing care for patients. So much of medicine is driven by guess work, and a system of educated trial and error – with patients ultimately paying the price for errors. What CER aims to do is provide clinicians – and patients – with empirical evidence of what treatments, procedures and diagnostics work best.

The priority areas laid out by the IOM sets the course for a comprehensive approach to CER that calls for coordination of public and private strategies. It's one of the first few steps among many, many steps we'll need to take to ensure the health system is as effective and efficient as it could be. Now we need to focus on real examples of comparative effectiveness being done to start to dissect how this is really going to work.

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