Comments on: Health Reform Progress Report http://fightcolorectalcancer.org/policy_news/2009/10/health_reform_progress_report We envision victory over colorectal cancer Wed, 23 May 2012 21:37:02 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: Catherine Knowles http://fightcolorectalcancer.org/policy_news/2009/10/health_reform_progress_report/comment-page-1#comment-2271 Catherine Knowles Thu, 08 Oct 2009 23:29:48 +0000 http://fightcolorectalcancer.org/?p=6196#comment-2271 Laura - Thank you for taking the time to read the blog and to post such a thoughtful comment. You are absolutely correct that comparative effectiveness research (or CER) should not be used as a cost saving tool to the detriment of life saving and life extending treatments. Comparative clinical effectiveness research has been discussed as an avenue for producing information to help health care decision makers, such as patients, providers, and public and private payers, reach informed, evidence-based decisions. Although publicly supported by many governmental and non-governmental entities in the abstract, controversy about comparative clinical effectiveness research lies in its practice and implementation. Much of the controversy surrounding whether costs should be included in comparative effectiveness research lies in the questions: when, how, and by whom will the research results be used to make decisions? The issue is most controversial if results that include costs are used to make insurance reimbursement, pricing, or coverage decisions. Other important questions about CER research include the following: Which treatments would be studied? Would different types of treatment options, such as drugs and surgery, be compared to each other? Would the research methods include systematic reviews, decision models, and observational studies, as well as randomized trials? Who would oversee and review the studies’ methods, timing, and clinical endpoints? Which researchers and what expertise would be required to conduct the studies? How would the results be presented and used? How would the political support for the entity be maintained? The answers to these questions could have repercussions on many interested parties including physicians, patients, payers, manufacturers, researchers, and federal agencies. C3 is working to ensure that CER enhances patient outcomes. Stay tuned! Laura – Thank you for taking the time to read the blog and to post such a thoughtful comment. You are absolutely correct that comparative effectiveness research (or CER) should not be used as a cost saving tool to the detriment of life saving and life extending treatments.

Comparative clinical effectiveness research has been discussed as an avenue for producing information to help health care decision makers, such as patients, providers, and public and private payers, reach informed, evidence-based decisions. Although publicly supported by many governmental and non-governmental entities in the abstract, controversy about comparative clinical effectiveness research lies in its practice and implementation.

Much of the controversy surrounding whether costs should be included in comparative effectiveness research lies in the questions: when, how, and by whom will the research results be used to make decisions? The issue is most controversial if results that include costs are used to make insurance reimbursement, pricing, or coverage decisions.

Other important questions about CER research include the following:

Which treatments would be studied?
Would different types of treatment options, such as drugs and surgery, be compared to each other?
Would the research methods include systematic reviews, decision models, and observational studies, as well as randomized trials?
Who would oversee and review the studies’ methods, timing, and clinical endpoints?
Which researchers and what expertise would be required to conduct the studies?
How would the results be presented and used?
How would the political support for the entity be maintained?

The answers to these questions could have repercussions on many interested parties including physicians, patients, payers, manufacturers, researchers, and federal agencies. C3 is working to ensure that CER enhances patient outcomes. Stay tuned!

]]> By: Laura Morefield http://fightcolorectalcancer.org/policy_news/2009/10/health_reform_progress_report/comment-page-1#comment-2267 Laura Morefield Wed, 07 Oct 2009 16:15:08 +0000 http://fightcolorectalcancer.org/?p=6196#comment-2267 As a cancer patient, I am concerned about CER being used as a cost saving tool to the detriment of life saving and life extension. As it stands, the "standard" of holding off on colonoscopies until the patient is 50 gave me a false sense of security (my mother had a precancerous polyp at 70 years of age and the doctor told her to "have your children eat lots of broccoli." If he'd encouraged (and the medical establishment suggested a range of ages for testing) a more proactive approach, it's likely instead of being diagnosed with asymptomatic Stage IV colon cancer at 48 that I might have caught it at an earlier age and stage. Group think is not always best. As a cancer patient, I am concerned about CER being used as a cost saving tool to the detriment of life saving and life extension.

As it stands, the “standard” of holding off on colonoscopies until the patient is 50 gave me a false sense of security (my mother had a precancerous polyp at 70 years of age and the doctor told her to “have your children eat lots of broccoli.”

If he’d encouraged (and the medical establishment suggested a range of ages for testing) a more proactive approach, it’s likely instead of being diagnosed with asymptomatic Stage IV colon cancer at 48 that I might have caught it at an earlier age and stage.

Group think is not always best.

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