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Media Matters Fact Checked us on our Obamacare Translator: Comparative Effectiveness Research (CER) on June 19. In our original CER article, we argued that government intervention to compare health care methods was not necessary--private companies already do it. Here’s their entire post and our response to it:
FreedomWorks Wrong On CER
June 19, 2009 6:12 pm ET
On June 19, 2009, Joseph Onorati wrote a blog post on the FreedomWorks site titled "Obamacare Translator: Comparative Effectiveness Research." Mr. Onorati, however, is unaware of how unprofitable it would be for private firms to conduct comparative effectiveness research.ONORATI WRONGLY THINKS COMPARATIVE EFFECTIVENESS RESEARCH (CER) IS ALL ABOUT COST...
Mr. Onorati: "Comparative Effectiveness Research: This is the evaluation of health care policies to compare their effects relative to cost. Private companies use it to determine the most cost effective means of treating patients. Government may employ evidence from studies to ration health care." [FreedomWorks.org, 6/19/09, emphasis original]
Comparative Effectiveness Research Is The Comparison Of Medical Treatments. According to the Washington Post's Business Columnist, Steven Pearlstein, "comparative effectiveness research" refers to "research done by doctors and statisticians who troll through large number of patient records to determine, for any particular disease, which treatments work best." [Washington Post, 2/13/09]
According to the CBO study cited by Media Matters in the rest of their article, "The analysis may focus only on the relative medical benefits and risks of each option, or it may also weigh both the costs and the benefits of those options." [Emphasis added]
CER Supplements Physicians' Knowledge To Ensure The Best Treatment Is Provided To The Patient. David Dale, MD of the American College of Physicians testified in a House Ways and Means Committee hearing: "The availability of valid, comparative effectiveness data supplemented by the physician's clinical experience and professional knowledge, helps ensure that an effective treatment choice is made-one that meets the unique needs and preferences of the patient." [American College Of Physicians' Statement for the Record, 6/12/07]
So, CER, which is provided by private medical firms, might give doctors the knowledge to meet unique needs and preferences of patients.
...AND IS ALSO UNDER THE IMPRESSION THAT PRIVATE FIRMS CONSIDER FACTORS (I.E. HUMANS) OTHER THAN PROFITS
Mr. Onorati: "Private comparative effectiveness research would facilitate a drive toward competitive prices. Why spend more to remedy a problem caused by intervention when government could instead leave the market alone to drive down health care costs at no expense to the taxpayer? Comparative effectiveness research attempts to simulate the same outcomes that might arise in a free market economy but has taxpayers footing the bill instead of the insurance companies." [FreedomWorks.org, 6/19/09]
Conducting Research Trials Is Not Always Financially Beneficial For Private Companies.According to a December 2007 report released by the Congressional Budget Office titled Research on the Comparative Effectiveness of Medical Treatments: "For drug manufacturers, the costs of conducting additional trials to demonstrate safety and efficacy for a broader set of patients or conditions may outweigh the benefits from the increased sales that would result; in particular, the potential gains from finding a favorable result for a different population would have to be weighed against the risk that safety and efficacy could not be demonstrated conclusively." [CBO.gov, 12/07]
The very same CBO study cited by Media Matters continues, “Several private-sector organizations exist primarily or exclusively to assess medical treatments and technologies.”
Private Companies Only Compare Drugs When Seeking "To Make A Claim Of Superiority." According to a December 2007 report released by the Congressional Budget Office titled Research on the Comparative Effectiveness of Medical Treatments: "Clinical trials of new drugs must compare them to alternative medications only when the manufacturer wants to make a claim of superiority in its FDA-approved marketing materials or when giving trial participants a placebo would be unethical (for example, in the case of a study of AIDS drugs)." [CBO.gov, 12/07, parenthesis original]
The clinical trials to which the CBO refers are the trials conducted by the FDA. The FDA regulates marketing for drugs that prevents one drug maker from claiming that their drug is superior to others without FDA approval. Lifting that restriction along with removing various barriers that the FDA places before drug makers would go far to encourage more competition in comparative effectiveness research.
"Comparative Trials Can Be Risky For Manufacturers To Conduct." According to a December 2007 report released by the Congressional Budget Office titled Research on the Comparative Effectiveness of Medical Treatments: "A trial of two statin drugs, which was sponsored by the maker of one of those drugs, found that its competitor's product was more effective both at lowering cholesterol levels and at reducing the risk of mortality - illustrating the point that comparative trials can be risky for manufacturers to conduct." [CBO.gov, 12/07, parenthesis original]
Media Matters’ “Fact Check” in this paragraph chooses one of four examples of the effects of CER laid out by the CBO in their Dec. 2007 study. The others all have much more positive results. Media Matters should take more care in the future to actually use facts and tell the whole story when "fact checking" others.
A freer market in medical care would encourage private companies to invest more in comparative effectiveness research to find the best solutions for patients. Government intervention and taxpayer dollars are not necessary to provide doctors with the information they need to care for their patients.