No one can deny that our country’s health care spending is reaching an unmanageable level. In 2006 we spent over $2 trillion on health care and some experts predict that we’ll be spending twice that much by 2017. While you might assume that population growth is causing these increases—more people usually means more health care—we’re also seeing a rise in the amount of money that we spend on each person.

One of the major reasons that health care costs are skyrocketing is the increasing number of people who have chronic diseases—around half of all Americans have at least one. Chronic diseases are not cheap to treat and while medical breakthroughs are saving lives and improving quality of life, they’re also contributing to the steady rise in costs.

Medical advances can be confusing for patients trying to make informed treatment decisions. Digging through mountains of information on various options can be overwhelming, and differences in the data make it close-to-impossible to compare the effectiveness of treatments and procedures that are often developed at an astonishing rate. In order to give patients the information needed to make the best possible treatment decisions—and to find ways to address health care spending and efficiency—advocates are supporting a government-sponsored effort to conduct research that compares the effectiveness of various treatment options.

The Value of Comparison

There is currently very little reliable information out there on which treatments work best for which patients. The information that is available is not always easy for patients to access. This can complicate treatment decisions and results in patients who aren’t getting the highest quality care. Comparative effectiveness research (CER) includes studies that test products and procedures against each other to see which is more effective for certain patients.

If done well, this type of research can give us better information about the benefits of various treatment options. In some cases, the research may find that the lower cost option is more beneficial to patients with a specific disease or condition. This information can be very powerful. It can not only equip patients and their health care professionals with the tools to make superior treatment decisions, but it can also help to close the gaps between health care spending and quality. However, if not conducted properly, CER has the potential to limit access to treatments that could improve quality of care for some patients.

Federal Support for CER

CER is currently conducted by a number of federal agencies but their efforts are not coordinated and they lack proper funding. In recent years, policymakers have begun to see more value in conducting CER on new medical technologies. As a result, a number of proposals have been introduced in Congress that would more clearly define the role of the federal government in CER. None of these bills have been passed, but lawmakers in Washington are expected to introduce new legislation early next year.

This legislation will most likely include the creation of an institute that would support and guide CER and oversee the use of the information. The research results could be added to practice guidelines for health care professionals. They could also be made available to the public to help them make treatment decisions.

Opponents of government-sponsored CER worry that the information could be used to cut spending without taking into account the needs of the patient or the value that new treatments provide to society. It could become a justification for denying treatment options that have been judged too ineffective or expensive, and weaken patient-physician choice. This is why it’s important that any CER legislation be well-designed and focused on patient access and health outcomes.

Patient-Centered Legislation

Effective CER legislation must:

• Be a tool for improving patient care.
• Produce unbiased and reliable information.
• Apply research results fairly and effectively.
• Support the right of patients and health care professionals to choose the best treatment options.
• Promote medical innovation.
• Encourage smarter spending without denying access to innovative treatment options.

Sharing Your Thoughts

Now is the time to have your voice heard. While Congress has not yet reached a consensus on many of the details, they expect to introduce legislation in early 2009. The Alliance for Aging Research is working with other organizations to ensure that CER legislation is used to promote quality care delivery and empower patients and physicians to make informed health care decisions. Contact your Senators and Congressperson and let them know that you too support CER that protects patient access and promotes medical innovation.