Panel Suggests 100 Priorities For Comp. Effectiveness Research

An Institute of Medicine panel released a list of 100 priorities for comparing the effectiveness of medical treatments as part of a $1.1 billion, stimulus-funded research program on Tuesday, the Associated Press reports. The recommendations – which are not official, but will likely influence government decisions – include comparing treatments for atrial fibrillation, an irregular heartbeat, prostate cancer, age-related hearing loss, attention deficit hyperactivity disorder and lower back pain. Also, the panel suggested comparing strategies for reducing hospital-acquired infections and unwanted pregnancies (Neergaard, 6/30).

"The report is one of the first concrete steps in a broad effort by administration officials and health experts to shift the focus of medical practice toward scientific evidence — rather than a physician’s personal views or treatments promoted by medical product companies," the New York Times reports. "Supporters of comparative effectiveness reviews include many medical researchers, consumer groups, unions and insurers. They say such studies are essential to curbing the widespread use of ineffective treatments and to helping control health care costs, which totaled $2.2 trillion in 2007, or 16 percent of the nation’s gross domestic product." Meanwhile, a co-chairman of the panel said the response of medical product companies, often among the critics of this form of research, was "muted" (Meier, 6/30).

In addition, patient rights groups have said the research could limit their choices. "Some worry that comparative research will ultimately lead to treatment decisions based on price. In the U.K., the National Institute for Health and Clinical Excellence has denied rheumatoid arthritis patients access to Bristol-Myers Squibb's Orencia because the health-care agency decided it was too costly," the Wall Street Journal reports. "Proponents say that isn't the plan in the U.S." (Yao, 6/30).

The recommendations do, however, target specific drugs in some cases, such as a type of arthritis drug produced by major pharmaceutical makers. Bloomberg reports, "studies should compare the effectiveness of the drugs, including Remicade from J&J, and Enbrel, marketed by Wyeth and Amgen, in a family of medicines linked to cancer" (Rapaport, 7/1).

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