Comparative effectiveness research holds out the tantalizing prospect of making it easier for patients and their doctors to choose the best treatment, thus improving quality. At the same time, it could also justify denying or reducing payment for a host of treatments or procedures that may be clinically ineffective or unworthy of their high price.
Analysts and policy makers advocate creating an entity that would conduct effectiveness research to allow payers, physicians and the public to make more evidence-based decisions about available treatment options. The Institute of Medicine and the Congressional Budget Office have recently recommended that such research be pursued.
But many questions remain unanswered. Who should conduct such research — government, the private sector or some combination? Who should decide which interventions to evaluate? Who will pay for it? What lessons, if any, can be drawn from existing comparative effectiveness programs in the public sector, private sector and abroad? How will evidence-based research be balanced against appropriate provider discretion? This briefing, cosponsored by the Robert Wood Johnson Foundation, addressed these and related questions.
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