Thursday, March 12, 2009

New debate on how to decide best health treatments

WASHINGTON – People's lives and plenty of money are at stake when it comes to determining which medical treatments work best.

So some prominent health industry and patient advocacy groups are trying to reframe the debate over how such decisions are made in order to ensure their interests are protected.

Spurred by $1.1 billion in the recent economic stimulus bill for "comparative effectiveness research," their coalition was unveiling a new campaign Thursday with a prominent Democrat and disability rights advocate, former California Rep. Tony Coelho, as its spokesman.

Coelho, who suffers from epilepsy and was a key sponsor of the Americans With Disabilities Act, said the issue comes down to whether disabled people and other patients would get the medical care they need.

"On this issue we need to be at the table," Coelho said in an interview with The Associated Press prior to Thursday's announcement of his new role. "Comparative analysis is wonderful, if it's done appropriately."

Coelho's concerns about what could happen if it's not done right line up with those articulated most loudly until now by Republicans and conservative commentators — that "comparative effectiveness" could morph into "cost effectiveness," with bean-counting government bureaucrats refusing treatments to patients who need them.

It's a big concern for drug and biotech companies too since they could lose out if a treatment they've developed is found to be less effective than a competitor's. But a drug company's bottom line isn't likely to draw as much public sympathy as a disabled person's needs.

That makes Coelho a good face for the Partnership to Improve Patient Care, which formed as the issue began to surface last fall and is funded by groups including the Easter Seals, Friends of Cancer Research, the Alliance for Aging Research, the Advanced Medical Technology Association and the powerful pharmaceutical and biotech industry lobbies.

Obama administration officials have sought to quell concerns over comparative effectiveness research, insisting their goal is simply to make health care more effective and efficient.

Obama's budget director, Peter Orszag, told a Senate committee this week that the research would "help patients and providers get the information they need for the highest quality care."

"The information from this research should help improve the performance of the U.S. health care system," Orszag said.

But controversy was stoked when language accompanying a House version of the bill suggested the result of comparative effectiveness research would be that less effective and in some cases more expensive procedures "will no longer be prescribed."

The final bill used different language, specifying there was no intention to "mandate coverage, reimbursement or other policies for any public or private payer."

Minority and women's groups have concerns about comparative effectiveness research too, saying they can be underrepresented in studies of medical procedures. The Partnership to Improve Patient Care counts a handful of such groups as member organizations, including the Society for Women's Health Research and MANA, a Hispanic women's advocacy group, though they don't provide funding for the group.