Comparative Effectiveness: Who Decides the Best Treatment for You?
As a medical writer and editor, I’ve been seeing lots of controversy surrounding the concept of comparative effectiveness lately. It sounds good in theory, but so far, the execution leaves something to be desired. In short, comparative effectiveness is simply looking at two (or more) treatments for a certain ailment and determining which is the most effective. Sounds good, right? But what if a drug works for 75% of the people but not 25% of the people, and insurance covers only the drug that’s most effective 75% of the time? And what if you’re in the other 25%?
That’s what Peter Pitts’ op-ed piece “A Test of Bad Health” is all about:
[Comparative effectiveness] sounds reasonable. But it will most likely result in Medicare covering fewer breakthrough medicines, which would, in turn, force doctors to prescribe only the drugs that Medicare will pay for — not the ones that are best for the patient.
Why? Drugs must be tested on large, representative populations that must be monitored for years. Because conducting these studies is so tricky, their findings are regularly overturned or modified by further research. In fact, some are so off the mark that doctors ignore them.
But if Medicare starts using flawed studies like these to determine its list of covered drugs, doctors will have to give them respect they probably don’t deserve. There’s also an inherent conflict of interest when the government conducts comparative-effectiveness studies and then uses those studies to determine which pills are worth buying. The more drugs the government classifies as “wasteful,” the more money it saves.
What do you think? Are you for or against comparative medicine?
Tags: comparative-effectiveness, coverage, insurance, medicare, woman, women, Womens-HealthRelated Stories
POSTED IN: Controversial issues, Medicine, Medicines/medications, Public policy, Real life
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