Is the Insurance Industry Getting Behind Comparative Effectiveness Research?

Is the Insurance Industry Getting Behind Comparative Effectiveness Research?
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This week many watched as the president joined with the largest associations of insurers and doctors to acknowledge the excessive costs of health care and the burdens it places on working families. While many who advocate for patients, consumers and workers' rights are skeptical of the industry's real commitment, we can all acknowledge that the mere announcement is a major breakthrough.

Part of the industry's recent commitment is to encourage treatment and care that is based on sound evidence and proven effectiveness. Groups like AARP and Consumers Union have long supported these efforts to improve care for patients through comparative effectiveness research. Fully 30 percent of the $2.4 trillion we spend per year on health care does not even benefit patients.

Previously, many in the health care industry have denied the inefficiencies and overblown costs in our health care system. Driven by a 'profit over patients' model these groups have worked hard to maintain the status quo and fight reforms designed to cut back on waste and fraud.

Part of this turnaround is due to the fact that these groups see the writing on the wall. They know that Americans want reform and they want it now. And they know that those who stand in the way or act as obstructionists will not have a seat at the table when reform happens.

President Obama has been a powerful voice in advocating for the best and most efficient care and treatments. Recently he spoke out for the first time about a deeply emotional health care decision that he was forced to make when his grandmother who was diagnosed with terminal cancer fell and broke her hip, and needed surgery. Obama thoughtfully advocated for a national conversation to help give guidance to other families faced with these difficult decisions.

What President Obama and many doctors, scientists and stakeholders have called for is for doctors and patients to have more access to the latest and best research to help them make informed decisions about what treatments make sense.

Who wouldn't want a doctor armed with more information about which drugs are most effective and which treatments work the best? This allows doctors and patients to choose the best course of action and not waste time or money on unnecessary tests and less effective treatments or drugs.

Our current health care system is plagued by inefficiencies, slow delivery of services, exorbitant and often unnecessary costs. This dangerous model not only fails to provide the best possible care for patients but it also causes economic hardship to the most vulnerable in our society - the sick and elderly.

Currently, drug and device companies don't have to prove that new devices and new drugs work better than current products or treatments. This lends itself to a confusing array of information for patients and doctors who often don't know the benefits of one drug or device from the next.

In addition, doctors don't have an efficient amount of comparative research on which to base their health care decisions. A report by the Congressional Budget Office (CBO) states that "some experts believe that less than half of all medical care is based on or supported by adequate evidence about its effectiveness."

Across the country, patients and doctors are implementing new and innovative treatments, common sense best practices and streamlined health care delivery. But these efforts shouldn't be piecemeal. The likelihood of patients benefiting from these should not be as random as the lottery.

The same CBO study shows that the use of certain treatments, as well as how often patients visit a physician, varies widely from one area of the country to another. For instance, whether a patient has heart bypass surgery, a hip or knee replacement or back surgery often has little to do with rates of heart attacks or injury to knees, hips and backs.

Comparative research would help bridge this gap between affordability and efficiency while putting the patient first. Everyone who is sick should have access to the best treatments and most efficient care regardless of income or where they live in the country.

We hope that the industry acts on its pledge and gets behind the need for comparative effectiveness research. This may mean making some hard decisions that don't benefit their bottom line in the short term. It may mean doing away with inefficient practices that don't help patients but are a big money maker for insurance companies.

Patients deserve to have doctors who are well informed about the best treatments so they can make the best decisions possible. Improved access to research can have benefits across the board. Patients will have better and more informed care and taxpayers will be less burdened by costly inefficiencies. It may not pad the pockets of the drug and insurance industry but it will make a difference in the lives of people.

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