It should come as no shock to anybody that Paul Krugman is touting comparative effectiveness research.
Krugman recently wrote: “Health care costs are the main reason long-term fiscal projections look so scary — and here we have corporate interest trying to prevent us, not from trying to spend our health dollar more wisely, but from even trying to find out what we get for the health care dollar.”
He adds: “This is truly vile.”
If Krugman was genuinely interested in mitigating costs, he would happily support pharmaceutical innovation, physician empowerment, shortening the FDA approval process, interstate purchase of health insurance and tort reform. He supports none of these reforms because his animus for the pharmaceutical industry and the free market trump meaningful reform that would benefit physicians and patients alike.
Moreover, his attempt to portray CER as a positive move towards cutting wasteful health spending is belied by recent statements from members of Congress and by the very actions of NICE in Britain in recent years.
Congressman Charles Boustany, a cardiovascular surgeon, recently expressed concern that “federal bureaucrats will misuse this research to ration care, to deny life-saving treatments to seniors and disabled people.” (To view CMPI’s interview with Congressman Boustany last year, click here)
Senator Tom Coburn, the only physician serving in the US Senate, has said of CER: “It is ludicrous to ask a body that can’t track its own spending to determine which medical treatments are best for individual patients suffering from complex diseases. The only reason to fund this project now is to lay the groundwork for establishing a government board that will be empowered to make life and death decisions about health care treatments and cost.”
Then we have others in Congress like Congressman David Obey, the Chairman of the powerful House Appropriations Committee, who say: “By knowing what works best…those items, procedures, and interventions that are most effective..will be utilized, while those that are found to be less effective and in some cases, more expensive, will no longer be prescribed.”
For a better perspective of the consequences of CER policies, we need look no further than Britain.
Just recently the courts struck yet another blow to NICE in Britain by ordering it to reconsider its policy of restricting certain drugs to women suffering from osteoporosis.
From the article:
“Under NICE guidelines, doctors can only prescribe the cheapest drug alendronate even though it is not tolerated by one in four women.
“Such women must wait up to five years until their condition worsens by up to 60 per cent before they are allowed alternative medication, such as the drug strontium ranelate.”
Dr Tim Spector, a rheumatologist at St Thomas’ Hospital, praised the court ruling:
'Many of my patients are unable to tolerate the treatment recommended by Nice under the current guidance but I have to wait for their disease to deteriorate before I can give them an alternative treatment. This would leave them unprotected from the risk of fracture for many years.
'The court decision will provide us with the opportunity to review the guidance and the economic assumptions made by Nice.
'This will hopefully result in new simpler and more flexible guidance in which clinicians have a real choice in the prescribing decisions they make for women with osteoporosis, who are all individuals with individual needs.'
This is what comparative effectiveness research has done for patients in Britain – bureaucrats denying drugs and treatments.
It’s a sad commentary on our times when politicians, economists, and reporters are so shameless as to openly advocate that government decide who deserves to live or die. No matter how you slice it, that is undoubtedly the intent of “comparative effectiveness research.”
Now that’s truly vile.
