Front-page article in today’s New York Times on the $1.1 billion for comparative effectiveness.
The complete article (by Robert Pear) can be found here.
Pear writes, “Under the legislation, researchers will receive $1.1 billion to compare drugs, medical devices, surgery and other ways of treating specific conditions. The bill creates a council of up to 15 federal employees to coordinate the research and to advise President Obama and Congress on how to spend the money.”
Let’s not kid ourselves. This is really about head-to-head drug trials. Is anyone even paying lip service to anything else?
According to Pear, “The program responds to a growing concern that doctors have little or no solid evidence of the value of many treatments.”
Really? No solid evidence? What about all those journal articles? What about professional guidelines? What about the growing availability of outcomes data?
“Little or no solid evidence.” In other words, evidence generated by the pharmaceutical industry doesn’t count -- but government research (like CATIE and ALLHAT) does. Talk about politics trumping science!
Pear reports that, “Women and members of minority groups expressed concern about that approach. Drugs and other treatments can affect different patients in different ways, they said, but researchers often overlook the differences because their studies do not include enough women, blacks or Hispanics … The final bill says that the research financed by the federal government shall include women and members of minority groups.”
That’s nice. But when you use the same 20th century tools for clinical trial design – you get the same 20th century data. It’s important to note that not one cent of the stimulus bill went towards the development of 21st century drug development and regulatory tools – precisely what the FDA’s Critical Path program is designed to address.
Here are a couple of other important issues that are rarely mentioned:
(1) Pharmaceuticals represent about 11.5% of our national healthcare spend – about the same as the rest of the developed world. 7% of that expense is for on-patent drugs.
(2) Generic drugs represent 56% of the volume and 4.5% of the spend. And both of those numbers are growing.
(3) The way to “save lives” is to make sure that the right patient gets the right medicine in the right dose at the right time. Whether or not they save money depends on where you sit and who you ask.
“The new research will eventually save money and lives,” said Representative Pete Stark (D, CA), chairman of the Ways and Means Subcommittee on Health.
Really Congressman? In that order?
Where you stand often depends on where you sit. If you’re a payer (either public or private), saving money can often mean denying expensive end-of-life care. If you’re a patient, well, you might have another view.
Pear writes, “Britain, France and other countries have bodies that assess health technologies and compare the effectiveness, and sometimes the cost, of different treatments.”
“Sometimes?” Come on. As Aldous Huxley wrote, “Facts do not cease to exist because they are ignored.”
Pear repeats what drugwonks.com shared on February 12, that the House Appropriations Committee (in a report accompanying its version of the economic recovery bill) said that research comparing different treatments could “yield significant payoffs” because less effective, more expensive treatments “will no longer be prescribed.” For more on this see “The UnCERtainty Principle.”)
If we want to provide excellent care and save money, there are two crucial public health issues that are being ignored by our elected representatives:
(1) Early diagnosis/prevention. No monies for either of these two items in the stimulus package.
(2) Compliance programs. According to a Harris survey, one in three (33%) U.S. adults who have been prescribed drugs to take on a regular basis report that they are often or very often noncompliant with their treatment regimens for any number of reasons.
Early diagnosis, prevention programs, and compliance issues are huge pieces of the healthcare cost pie – but not, it seems, sexy enough from a political talking point perspective.
No doubt members of Congress will say that such things will be addressed when we debate health care reform.
But isn’t that what we’re doing now?
The complete article (by Robert Pear) can be found here.
Pear writes, “Under the legislation, researchers will receive $1.1 billion to compare drugs, medical devices, surgery and other ways of treating specific conditions. The bill creates a council of up to 15 federal employees to coordinate the research and to advise President Obama and Congress on how to spend the money.”
Let’s not kid ourselves. This is really about head-to-head drug trials. Is anyone even paying lip service to anything else?
According to Pear, “The program responds to a growing concern that doctors have little or no solid evidence of the value of many treatments.”
Really? No solid evidence? What about all those journal articles? What about professional guidelines? What about the growing availability of outcomes data?
“Little or no solid evidence.” In other words, evidence generated by the pharmaceutical industry doesn’t count -- but government research (like CATIE and ALLHAT) does. Talk about politics trumping science!
Pear reports that, “Women and members of minority groups expressed concern about that approach. Drugs and other treatments can affect different patients in different ways, they said, but researchers often overlook the differences because their studies do not include enough women, blacks or Hispanics … The final bill says that the research financed by the federal government shall include women and members of minority groups.”
That’s nice. But when you use the same 20th century tools for clinical trial design – you get the same 20th century data. It’s important to note that not one cent of the stimulus bill went towards the development of 21st century drug development and regulatory tools – precisely what the FDA’s Critical Path program is designed to address.
Here are a couple of other important issues that are rarely mentioned:
(1) Pharmaceuticals represent about 11.5% of our national healthcare spend – about the same as the rest of the developed world. 7% of that expense is for on-patent drugs.
(2) Generic drugs represent 56% of the volume and 4.5% of the spend. And both of those numbers are growing.
(3) The way to “save lives” is to make sure that the right patient gets the right medicine in the right dose at the right time. Whether or not they save money depends on where you sit and who you ask.
“The new research will eventually save money and lives,” said Representative Pete Stark (D, CA), chairman of the Ways and Means Subcommittee on Health.
Really Congressman? In that order?
Where you stand often depends on where you sit. If you’re a payer (either public or private), saving money can often mean denying expensive end-of-life care. If you’re a patient, well, you might have another view.
Pear writes, “Britain, France and other countries have bodies that assess health technologies and compare the effectiveness, and sometimes the cost, of different treatments.”
“Sometimes?” Come on. As Aldous Huxley wrote, “Facts do not cease to exist because they are ignored.”
Pear repeats what drugwonks.com shared on February 12, that the House Appropriations Committee (in a report accompanying its version of the economic recovery bill) said that research comparing different treatments could “yield significant payoffs” because less effective, more expensive treatments “will no longer be prescribed.” For more on this see “The UnCERtainty Principle.”)
If we want to provide excellent care and save money, there are two crucial public health issues that are being ignored by our elected representatives:
(1) Early diagnosis/prevention. No monies for either of these two items in the stimulus package.
(2) Compliance programs. According to a Harris survey, one in three (33%) U.S. adults who have been prescribed drugs to take on a regular basis report that they are often or very often noncompliant with their treatment regimens for any number of reasons.
Early diagnosis, prevention programs, and compliance issues are huge pieces of the healthcare cost pie – but not, it seems, sexy enough from a political talking point perspective.
No doubt members of Congress will say that such things will be addressed when we debate health care reform.
But isn’t that what we’re doing now?
