Thursday, May 19, 2011

Comparative-Effectiveness Research: How Many Lives Will It Cost?

I write a lot over at John Goodman's Health Policy Blog.  For every original post, I also write about half a dozen comments on others' posts.  I don't usually share the latter here.

However, I was interested to see Dr. Goodman's take on a new paper published by the Center for Medicines in the Public Interest, an outfit which is often tagged as simply a mouthpiece for Big Pharma.  Here's what I wrote:
Yes, I certainly appreciated the last “dig” and I shake my head at the irony of PhRMA funding research designed to push back key elements of a law for which PhRMA lobbied and invested. I doubt that Obamacare would have passed without PhRMA’s support. If PhRMA had resisted Obamacare, the threat of Comparative-Effectiveness Research (CER) would not be nearly as great as it is today.

But that is water under the bridge. IMHO, Vernon & Goldberg have written a very good paper. Deriving a point estimate from one factor in a function that has many factors is obviously risky, but they have used scholarly sources appropriately. And they are obviously trying to have an impact on public policy so they communicated their findings in such a way as to generate as much “heat” as possible.

Isn’t that why we are in think tanks and not academic departments at universities? So that our research has impact in the real world and not just in articles in scholarly journals that few read?

If we are going to challenge people solely based on where they get their funding, without considering the work, then we must logically accept only research by amateur gentlemen who do if for free! I don’t think anyone fits that bill.

Even if we think the point estimate derived by Vernon & Goldberg is overconfident, it complements a principle that we champion: CER cannot be effectively achieved by a centralized bureaucracy. CER can only be effective when millions of patients, prescribers, scientists, and entrepreneurs are trying new medicines free of central control.

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