• Study Suggests Comparative Effectiveness May Not Lead to Reductions in Healthcare Spending
  • September 23, 2009 | Author: Kerrie S. Howze
  • Law Firm: King & Spalding LLP - Atlanta Office
  • The results of a RAND Corporation study released on September 8, 2009, suggest that comparative effectiveness research, which examines the degree to which alternative treatments for the same health problems produce equivalent or different outcomes, may not lead to reduced healthcare spending. Theoretically, comparative effectiveness research drives down medical spending costs by identifying more productive, less costly treatment options and communicating these options to providers, patients, and insurance companies to assist with treatment decisions, benefit design, coverage determinations, and payment.

    According to the study, however, while comparative effectiveness research may reduce spending for certain diseases, currently there is no clear empirical data suggesting that large scale comparative effectiveness research will result in overall savings to the U.S. healthcare system, and obtaining such evidence could itself be costly. In the near term, any cost-savings benefits would be offset by the costs of the research studies themselves. Although synthesis of existing research is less costly than conducting new studies, new studies likely will be necessary to research specific questions about preferred approaches to treatment.

    The usefulness of new research studies, however, remains uncertain, according to the study. New studies must overcome inherent design challenges to produce useful data. Moreover, the benefits to the U.S. healthcare system as a result of these costly new studies are difficult to predict, since such benefits depend on the results of the studies themselves, how the information is disseminated, and ultimately how effective the information is at influencing clinical practice.

    Significant federal stimulus funding for comparative effectiveness research undoubtedly indicates that the research will continue. The American Recovery and Reinvestment Act of 2009 (ARRA), Pub. L. No. 111-5, recently allocated $1.1 billion for comparative effectiveness research to the Agency for Healthcare Research and Quality (AHRQ) ($300 million), the National Institutes of Health (NIH) ($400 million), and the Office of the Secretary of Health and Human Services ($400 million). These newly allocated funds are in addition to funds currently being spent on comparative effectiveness research by AHRQ, NIH, the Centers for Medicare and Medicaid Services, the Department of Veterans Affairs, and the Office of the National Coordinator for Health Information Technology.