The Promise of Comparative Effectiveness Research

Abstract

Medicare must find new ways to achieve cost control without limiting access to beneficial services. We propose a payment model incorporating comparative effectiveness research to encourage Medicare to pay equally for services that provide comparable patient outcomes. The model would include higher payments for services demonstrated by adequate evidence to provide superior health benefits compared to alternative options. New services without such evidence would receive usual reimbursement rates for a limited time but then be reevaluated as evidence emerged. In spite of the substantial political hurdles to changing Medicare reimbursement, efforts should be made to use comparative effectiveness research to reward superior services, improve incentives for cost-effective innovation, and place Medicare on a more sustainable financial footing.

The clinical effectiveness of evidence-based interventions for depression: A pragmatic trial in routine practice

“…This translational research aims to convert the results from clinical studies into everyday clinical practice (Sullivan and Goldmann, 2011;Woolf, 2008).…”

Stress management interventions for HIV-infected individuals: review of recent intervention approaches and directions for future research

“…Adaptive clinical trials allow for planned, reactive treatment changes throughout the trial based on initial treatment response. 110,111 Thus, for PLWHA who do not demonstrate improved psychological functioning after receiving a stress management intervention, such an approach could facilitate appropriate treatment referrals for more intensive psychiatric or substance use services.…”

Comparative Effectiveness Research (CER): A Summary of AHRQ"™s CER on Therapies for Rheumatoid Arthritis

“…At present this issue is not clear; however, an attractive alternative, called pragmatic clinical trials, has been described by Sullivan and Goldmann (2011), as well as others. 6 Pragmatic clinical trials are prospective in nature but address the issue of external validity by enrolling the full range of patients that clinicians in practice will see as potential candidates to use the drug of interest. A component of CER will include primary studies which develop new evidence through original studies that make head-to-head comparisons of treatment alternatives for a condition or a disease.…”