Far removed from Betsy McCaughey's fever dreams, Merrill Goozner has a good post detailing the strings attached to the $1.1 billion in comparative effectiveness money that came with the stimulus package. The House won a victory, he says, retaining the very term "comparative effectiveness." The Senate version bowed to industry pressure and funded "clinical effectiveness." Knowing whether something is clinically effective in not necessarily helpful in knowing which clinically effective therapy to employ. It's the same problem we have now: Lots of treatments with little information helping us choose between them. But it's not clear whether the information we'll have will be the information we need. The conference report specifies that the funding "shall be used to conduct or support research to evaluate and compare the clinical outcomes, effectiveness, risk, and benefits of two or more medical treatments and services that address a particular medical condition." It says nothing about taking cost into consideration. The research thus could not distinguish between the benefits of a pricey medicine that acts in four days and a cheap medicine that takes a week. And this comes in context of a bill that already specifies that Congress does "not intend for the comparative effectiveness research funding included in the conference agreement to be used to mandate coverage, reimbursement, or other policies for any public or private payer." It's strange to even have to say this, but if we're not willing to even research cost effectiveness, we're never going to get costs under control.
