Comparative Effectiveness — Thinking beyond Medication A versus Medication B | Health Care Reform 2009

Kevin G. Volpp, M.D., Ph.D., and Anup Das The American Recovery and Reinvestment Act of 2009 (ARRA), the stimulus package signed into law by President Barack Obama on February 17, 2009, directs $1.1 billion to support “the development and dissemination of research assessing the comparative effectiveness of health care treatments and strategies, including through efforts that . . . conduct, support, or synthesize research that compares the clinical outcomes, effectiveness, and appropriateness of items, services, and procedures that are used to prevent, diagnose, or treat diseases, disorders, and other health conditions.” The rationale for seeking better information on comparative effectiveness is well understood. Many existing devices and therapeutic approaches have never been subjected to the scrutiny of randomized, controlled trials comparing them with placebos, and even fewer have been directly tested against other approaches to improving the health of people with a given condition. Though there is controversy over whether such evaluations should include information on cost-effectiveness and how the findings should be used in coverage decisions, there is little debate that both health care professionals and the public will benefit greatly from better data to inform their choices among the available therapies for a given condition. Read More