Through AHRQ and Medicare (and with the explicit editorial support of the NEJM) CER is being used to slow down the development and access to new medical technologies without regard to or understanding about the impact to individuals. CER or HTA is the operating system of Obamacare. And as I noted in my previous blogs, AHRQ has more money to slow down the use of new technologies than FDA's Center for Drug Evaluation and Research has for review new products.
Apart from the dangerous and bizaare indulgence of the whims of anti-vaccine and anti-science groups, AHRQ's role in developing studies and evidence standards for use of personalized medicine, targeted therapies, nanotechnology, drug/diagnostic combinations, etc.. (studies conducted by a small group of organizations that include those controlled by HMOs who also control the funding decisons made by AHRQ) for HMOs, Medicare, Medicaid, etc will impose significant costs on innovation and well-being.
Most recently the FDA approved the use of Crestor as a preventive treatment for heart disease using hsCRP tests to identify those specific patients who might benefit. Clearly a step towards targeted and prudent use of statins. Women were found to benefit more than men from early intervention. Yet ARHQ's recommendation to the US Preventive Services Task Force was to NOT use hsCRP tests in primary care settings until there were more randomized trials..
Continuing to impose the barrier of randomized trials on all new individualized technologies is tantamount to creating Jim Crow laws for personalized medicine. And indeed, the impact of using expensive randomized trials to test everything new will be to make fewer new things available without knowing which are valuable to who.
Which is the point of bending the curve: slowing consumption of new technologies across the board to free up money for bigger entitlements. Unfortunately, the use of older and cheaper more often does not translate into better health and lower costs.
Republicans and Democrats who truly want a serious American effort to improve health care should shun the White House offer of media exposure and concentrate on getting better information on what my colleague Peter Pitts calls the four health care rights of the 21st century: the right medicine for the right person for the right reason at the right time. Such rights increase wellbeing and improve value. Scrapping AHRQ's agenda and conflicted approach to pursuing it is the first step in that healthy direction
Apart from the dangerous and bizaare indulgence of the whims of anti-vaccine and anti-science groups, AHRQ's role in developing studies and evidence standards for use of personalized medicine, targeted therapies, nanotechnology, drug/diagnostic combinations, etc.. (studies conducted by a small group of organizations that include those controlled by HMOs who also control the funding decisons made by AHRQ) for HMOs, Medicare, Medicaid, etc will impose significant costs on innovation and well-being.
Most recently the FDA approved the use of Crestor as a preventive treatment for heart disease using hsCRP tests to identify those specific patients who might benefit. Clearly a step towards targeted and prudent use of statins. Women were found to benefit more than men from early intervention. Yet ARHQ's recommendation to the US Preventive Services Task Force was to NOT use hsCRP tests in primary care settings until there were more randomized trials..
Continuing to impose the barrier of randomized trials on all new individualized technologies is tantamount to creating Jim Crow laws for personalized medicine. And indeed, the impact of using expensive randomized trials to test everything new will be to make fewer new things available without knowing which are valuable to who.
Which is the point of bending the curve: slowing consumption of new technologies across the board to free up money for bigger entitlements. Unfortunately, the use of older and cheaper more often does not translate into better health and lower costs.
Republicans and Democrats who truly want a serious American effort to improve health care should shun the White House offer of media exposure and concentrate on getting better information on what my colleague Peter Pitts calls the four health care rights of the 21st century: the right medicine for the right person for the right reason at the right time. Such rights increase wellbeing and improve value. Scrapping AHRQ's agenda and conflicted approach to pursuing it is the first step in that healthy direction
