As the Senate seeks to slash billions from the spending bill many legislators have focused on the $1.1 billion that would go to the Agency for Healthcare Research and Quality for "comparative effectiveness research" for elimination and future consideration in a more timely and deliberative fashion. This would be a wise move for the following reason:
1. The additional spending does not stimulate the economy. The money would be spent on consulting contracts for health care economists.
2. The way in which the money would be spent is neither transparent or clearly defined. Indeed, nearly a half a billion dollars would be spent at the discretion of the HHS secretary without outside review, establishment of research goals or methodologies:
Directs $400 million to be made available for comparative effectiveness research to be allocated at the discretion of the Secretary of HHS. Funds appropriated shall be used to accelerate the
development and dissemination of research assessing the comparative effectiveness of healthcare treatments and strategies, including efforts that 1)
conduct, support, or synthesize research that compares the clinical outcomes, effectiveness, and appropriateness of items, services, and procedures that are used
to prevent, diagnose, or treat diseases, disorders, and other health conditions; and 2) encourage the development and use of clinical registries, clinical data
networks, and other forms of electronic health data that can be used to generate or obtain outcomes data:
3. The rest of the money is a payoff to insurance companies and health plans who want the government to take over the job of deciding what technologies consumers should get and what doctors should get paid. The group advising AHRQ on what research organizations should get the money is made up mostly of insurers and Medicaid directors and the entities that would conduct the research are run by health plans themselves or consult for them directly. Another $700 million would go directly to AHRQ to be allocated by it's comparative effectiveness research "stakeholders" group to a group of "technology evaluation centers" that do most of the comparative effectiveness research for the agency. This is akin to giving the EPA money to evaluate air quality standards and turning the decision of which research to fund over to car makers and limiting the pool of research organizations to those supported by or consulting to the Big Three auto companies.
4. In other countries comparative effectiveness has has the effect of hurting patients and killing biotechnology, a leading source of economic growth and jobs. The National Institute of Clinical Excellence (NICE) in Britain is the model for the "coordinating council." It has been recently cited by patients in Britain for denying access to cancer drugs. The UK's BioIndustry Association recently noted: "an independent inquiry is necessary to assess NICE's long-term impact on the cost, access to, and uptake of medicines in the UK. As you know, NICE has been aggressive about rejecting expensive medicines that it says don't offer sufficient advantages over older, less costly drugs." This announcement came after it was discovered that the British health system had a $3 billion surplus and biotech companies were going broke.
http://www.bioindustry.org/biodocuments/BIGTR2/BIGT_Review_and_Refresh.pdf
http://www.fiercebiotech.com/story/uk-biotechs-ask-tax-breaks/2009-01-22
Giving over a billion dollars for a small cadre of self-interested appointees who could dictate and determine medical practice and the future of the biotechnology industry is a risky and unwise use of tax payer dollars under any circumstance. To suggest that it would stimulate the economy is to only add insult to injury.
1. The additional spending does not stimulate the economy. The money would be spent on consulting contracts for health care economists.
2. The way in which the money would be spent is neither transparent or clearly defined. Indeed, nearly a half a billion dollars would be spent at the discretion of the HHS secretary without outside review, establishment of research goals or methodologies:
Directs $400 million to be made available for comparative effectiveness research to be allocated at the discretion of the Secretary of HHS. Funds appropriated shall be used to accelerate the
development and dissemination of research assessing the comparative effectiveness of healthcare treatments and strategies, including efforts that 1)
conduct, support, or synthesize research that compares the clinical outcomes, effectiveness, and appropriateness of items, services, and procedures that are used
to prevent, diagnose, or treat diseases, disorders, and other health conditions; and 2) encourage the development and use of clinical registries, clinical data
networks, and other forms of electronic health data that can be used to generate or obtain outcomes data:
3. The rest of the money is a payoff to insurance companies and health plans who want the government to take over the job of deciding what technologies consumers should get and what doctors should get paid. The group advising AHRQ on what research organizations should get the money is made up mostly of insurers and Medicaid directors and the entities that would conduct the research are run by health plans themselves or consult for them directly. Another $700 million would go directly to AHRQ to be allocated by it's comparative effectiveness research "stakeholders" group to a group of "technology evaluation centers" that do most of the comparative effectiveness research for the agency. This is akin to giving the EPA money to evaluate air quality standards and turning the decision of which research to fund over to car makers and limiting the pool of research organizations to those supported by or consulting to the Big Three auto companies.
4. In other countries comparative effectiveness has has the effect of hurting patients and killing biotechnology, a leading source of economic growth and jobs. The National Institute of Clinical Excellence (NICE) in Britain is the model for the "coordinating council." It has been recently cited by patients in Britain for denying access to cancer drugs. The UK's BioIndustry Association recently noted: "an independent inquiry is necessary to assess NICE's long-term impact on the cost, access to, and uptake of medicines in the UK. As you know, NICE has been aggressive about rejecting expensive medicines that it says don't offer sufficient advantages over older, less costly drugs." This announcement came after it was discovered that the British health system had a $3 billion surplus and biotech companies were going broke.
http://www.bioindustry.org/biodocuments/BIGTR2/BIGT_Review_and_Refresh.pdf
http://www.fiercebiotech.com/story/uk-biotechs-ask-tax-breaks/2009-01-22
Giving over a billion dollars for a small cadre of self-interested appointees who could dictate and determine medical practice and the future of the biotechnology industry is a risky and unwise use of tax payer dollars under any circumstance. To suggest that it would stimulate the economy is to only add insult to injury.
