The differences between comparative and clinical effectiveness

With the passage of PPACA there is literally billions of dollars floating around just waiting to be spent. Of course all of these dollars come with conditions, heavy ones. Peter J Pitts looks into how the distinction between clinical effectiveness research and comparative effectiveness research could likely be a very costly one....

Excerpt:

The Recovery Act of 2010 gave the Agency for Healthcare Research and Quality $1.1 billion to conduct, according to the Health and Human Services Department news release, “comparative effectiveness research” into various “healthcare interventions.”

Except that’s not what Congress funded. Per the act, that $1.1 billion was earmarked for clinical comparative effectiveness, notcomparative effectiveness research. And this is not splitting hairs. Enter cost-think.

Comparative effectiveness advocates favor large-scale trials that “compare” drugs and other health care “technologies,” striving to show which medicines are most effective for any given disease state. Comparative effectiveness means cost effectiveness.

Clinical effectiveness, on the other hand, measures outcomes on an individual patient level. Clinical effectiveness studies help us to understand how to design treatments based on patient variation rather than cost. This approach represents the very definition of personalized medicine.

The differences between comparative and clinical effectiveness are profound. By changing the legislative verbiage, the legislative intent is likewise altered.

Welcome to cost-think, where anything that has to do with health care reform must be entirely based on the philosophy of reducing short-term costs.

And nowhere is cost-think more crucial than when it comes to so-called “academic detailing” of publicly bankrolled comparative effectiveness research.

Welcome to the new "Newspeak."

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