The American Recovery and Reinvestment Act of 2009 provides federal funding towards something called "comparative effectiveness research". You may be wondering exactly what your tax dollars are paying for.
Comparative effectiveness research studies medical therapies and treatments to determine which ones most effectively combat disease. For example, comparative effectiveness research might be used to determine whether patients with certain types of cardiovascular illness benefit more from surgery or drug therapy.
Experts in health policy often engage in heated debate over whether cost should be a factor in comparative effectiveness research. Some believe that clinical effectiveness and patient outcomes should be the only factor to consider. Others believe that completely divorcing the cost issue from clinical effectiveness is unrealistic and can produce results that don't make much sense. For example, if Treatment A reduces the risk of debilitating symptoms from 15% to 5%, but costs 3 times as much as Treatment B, what does that really mean for us as a society when we're trying to determine how to most effectively spend on healthcare? Do we pay the additional money, even though the patient may have been among the 85% with no symptoms at all? Would your answer change if the patient is among the 3% that are going to experience symptoms anyway? There are no easy answers to these questions.
This is why comparative effectiveness is a controversial issue in the health policy community. Ultimately, there no easy answer to the question of what to do with the information obtained through comparative effectiveness research. Healthcare providers and consumer groups are concerned the research will be used bythird-party payers like insurance companies to deny payment for more expensive and/or non-standard treatment. Researchers, however, stand by their contention that this type of research will improve the quality of life for millions of Americans.
Sources:
Recovery.gov. Accessed March 2009. Holtz, Andrew. "ECRI Institute's 15th Annual Conference Report: Key Questions and Issues." Accessed March 2009.
