• Bad reporting on CER

    Health reporters bear some of the responsibility for passing on PhRMA-funded work in misleading news reports.  As reported in Fierce Healthcare:

    Comparative effectiveness research could cost the nation trillions of dollars in economic activity and shorten the lives of Americans, concludes a new report from the Center for Medicine in the Public Interest.

    Comparative effectiveness research is considered one of the cornerstones of healthcare reform, with its findings reaffirming certain medical practices and reducing excess or unnecessary care, notes Healthcare Finance News.

    However, a study by the non-partisan CMPI contends that using such research in streamlining healthcare delivery would stifle investment in researching new treatments and drugs.

    Some quick comments:

    1. CMPI isn’t “non-partisan” but is a PhRMA-funded think tank, according to SourceWatch.
    2. CER – if done right – will pay more for outstanding innovation and less for me-to drugs.  That sends better signals to the market, saving both lives and money.
    3. At least one of the authors of this study (John A Vernon at UNC Chapel Hill) should know better, since his family has a long history of academic research in the pharmaceutical sector.
    4. Perhaps the argument is that CER won’t be done right, that inept bureaucrats will punish the great drugs while rewarding the marginal.  If so, make that argument plainly in news stories like this.

     

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    • The study seems to make 2 questionable assumptions: first, that despite the money appropriated for CER, the government will not pay for any of the research and push the entire on to private companies developing new products, e.g. new medications; second, that new products won’t be allowed to enter the market if they are not more effective than other treatments. It seems far more likely that private and public funders will simply refuse to pay more for new products that aren’t more effective than they do for existing products.

    • There are tons of CER incidents that happen everyday that seem to fly under the radar

    • I am in complete agreement that there is too much bad reporting about academic research–findings are easily taken out of context; as a result, the reporting can be very misleading.

      There is also a lot of inept “criticism” by partisan academics who do not take the time to carefully read the research that is being cited in the media–or they have academic training in a very different discipline from the research being cited–or both.

      In Outterson’s quick comments above, he illustrates this point by his fourth comment (his first three comments have nothing to do with the study assumptions, methods, caveats cited by Goldberg et al., etc.).

      In my first reading of the technical version of the study at the CMPI website it was very clear that the impact on innovation being measured results from increased clinical trial costs associated with regulations requiring firms to run more trials against comparators relative to placebo (the authors are careful to note their analysis assumes a manifestation of CER regs that imposes these costs directly on firms, which they seem very careful to note may not be the case). The analyses also are based on differential rates of innovation in perpetuity (and over shorter time horizons) whereby innovation w/o marginal drug development cost-increasing regs is compared to the counterfactual rate of innovation with such *potential* regs.

      Two things seem very clear:

      1. The headlines about this study are indeed misleading; and
      2. The Outterson commentary on the media commentary is hypocritical and equally misleading.

      Conclusion: TWO WRONGS DON’T MAKE A RIGHT! The media and academic BOTH need to do their homework and try not to mislead their readers. But alas, this is surely too much to ask in this partisan world–especially in the sphere of health policy. Readers BEWARE!!

    • In the report that by the authors of the study at
      that I read and just reread I see no acknowledgement that they are making the assumption that firms will bear the entire cost. Are you looking. Is there different more complete description of the study?
      If we are looking at the same source, where do you see this explicit acknowledgement.

      They do acknowledge making the assumption that CER will be 50% of Phase III costs..

    • Yes, I was looking. I was looking at the study posted alongside the non-technical CMPI press release/report cited in your comment/post:

      The study assumptions and its methods are described on pages 7 through 10. Apparently these are based on analyses already published in 2010 in the journal PharmacoEconomics entitled “Comparative Effectiveness Regulations and Pharmaceutical Innovation.”

      You were only reading the press release by CMPI–albeit a rather long and convoluted one! This is why we have bad press reports re academic research: misleading press releases and misleading commentary about misleading press releases. Things go from BAD to WORSE when attention to detail is lax, or, more nefariously, when there is an explicit intent to mislead.

    • Thanks for all the comments. A few more:

      (1) The SourceWatch CMPI info is generally inaccurate.

      (2) This new CER report was not supported by any industry (or industry association) funding).

    • I found reading these comments enlightening. It seems to be the case that the original poster/commentator didn’t like some of the study’s conclusions, and thought: why not say anything I want to (w/o reading anything but the headlines). Perhaps he/she thought the ends justify the means b/c of his/her delusions of knowing better than society what is best for society. Paternalistic liberalism at its finest!!! But I’m not a lawyer, economist, or political scientist…and I will admit I haven’t read the report/study or researched who CIMP is, or how they are funded. ~KF (a moderate democrat). Peace on Earth!