The Policy Debate over Public Investment in Comparative Effectiveness Research
- Eugene C. RichAffiliated withProfessor of Medicine, Creighton University School of Medicine Email author
Policy makers across the political spectrum, as well as many clinicians and physician professional associations, have proposed that better information on comparative clinical effectiveness should be a key element of any solution to the US health-care cost crisis. This superficial consensus hides intense disagreements over critical issues essential to any new public effort to promote more comparative effectiveness research (CER).
Methods and Results
This article reviews the background for these disputes, summarizes the different perspectives represented by policy makers and advocates, and offers a framework to aid both practicing and academic internists in understanding the key elements of the emerging debate. Regarding the fundamental question of “what is CER,” disagreements rage over whether value or cost effectiveness should be a consideration, and how specific patient perspectives should be reflected in the development and the use of such research. The question of how to pay for CER invokes controversies over the role of the market in producing such information and the private (e.g., insurers and employers) versus public responsibility for its production. The financing debate further highlights the high stakes of comparative effectiveness research, and the risks of stakeholder interests subverting any public process. Accordingly there are a range of proposals for the federal government’s role in prioritization, development, and dissemination of CER.
The internal medicine community, with its long history of commitment to scientific medical practice and its leadership in evidence–based medicine, should have a strong interest and play an active role in this debate.
Key Wordscomparative effectiveness research (CER) cost effectiveness analysis (CEA) policy debate health care costs
- The Policy Debate over Public Investment in Comparative Effectiveness Research
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
Journal of General Internal Medicine
Volume 24, Issue 6 , pp 752-757
- Cover Date
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- comparative effectiveness research (CER)
- cost effectiveness analysis (CEA)
- policy debate
- health care costs
- Industry Sectors
- Author Affiliations
- 1. Professor of Medicine, Creighton University School of Medicine, 601 North 30th ST, Omaha, NE, 68131, USA