1. PIPC Steering Member, Alliance for Aging Research, Blog: Turning a Blind Eye on Patients, click here to view the post.
2. Inside Health Policy: All Sides Target Patients As Debate Rages Over Drug Innovation, Prices, click here to view the article.
3. PCORI, CQ HealthBeat, Bloomberg Comment On Annual Survey Of Comparative Effectiveness Research, click here to view the PCORI post, here to view the CQ HealthBeatarticle (subscription required), and here to view the Bloomberg article (subscription required).
4. PCORI Blog: New Funding Announcement Advances Pragmatic Studies Initiative, click here to view the post.
5. Healthcare Informatics: While Big Data Promises Big Changes in Health Care, Hurdles Remain, click here to view the article.
6. Harvard School of Public Health: Prevention in Public Health: What Works? Click here to view the full review.
7. PCORI Blog: Planning for Dissemination and Use of Results from PCORI-Funded Research, click here to view the post.
8. Wall Street Journal: The Bureaucrat Sitting on Your Doctor's Shoulder, click here to view the article.
9. The Hill, Politico: AHIP Comments on PCORI, click here to view The Hill article, and here to view the Politico Pro article (subscription required).
10. The Pink Sheet Daily: Part D Data-Sharing Expansion Stops Short Of Allowing Commercial Uses, click here to view the full article, subscription required).
11. Bloomberg: Most Doctors Prescribe Antibiotics That Don't Work, click here to view the article.
In response to a report released last week by the Center for American Progress, PIPC steering member Cynthia Bens penned the following blog post: “The Center for American Progress (CAP) released a report today claiming that the use of Lucentis for the treatment of age-related macular degeneration (AMD) wastes $1 billion a year. […] CAP’s report is based on Centers for Medicare & Medicaid Services Medicare physician payment data which included Lucentis, the drug approved by the Food and Drug Administration (FDA) to treat AMD, as one of the highest-volume costs in the data set. However, the CAP report focuses only on the cost of the drug as the cause for the high utilization rate, rather than the increasing number of older people who are requiring treatment for AMD as a result of advancing age and the graying of the population.
“The report would have you believe that the solution for slashing this $1 billion price tag is to promote the off-label use of a similar drug called Avastin, approved by the FDA to treat cancer. The off-label use of Avastin costs 40 times less than Lucentis per injection but the dirty truth is that many of these injections of Avastin are produced in compounding pharmacies that are not regularly inspected by the FDA. Because of lower standards for purity and a lack of inspection for compounding pharmacies, off-label use of Avastin for the treatment of AMD has been linked to more extensive and premature blindness[…] This is one of those cases where if the solution sounds simple you need to look deeper because it probably is too good to be true. Those of us who want more independence and improved quality of life for people as they grow older need to look beyond the cost of a drug. We don’t have the luxury of turning a blind eye on what is best for patients.” Click here to view the post.
2. Inside Health Policy: All Sides Target Patients As Debate Rages Over Drug Innovation, Prices
Last week, Inside Health Policy commented on the increased focus on patient-centered drug therapies. “As a national debate erupts over the pricing of new drug breakthroughs, lawmakers, drug makers, insurers and FDA are all seeking patients' help in their respective, and often competing, efforts to spur new drug cures, defend pricing and reimbursement strategies, ensure patient access and reduce health care costs. […]A new House committee initiative to speed approval of breakthrough drugs has also spurred debate over patients' role in risk-benefit analysis as policymakers increasingly turn to post-market data collection. The House Energy & Commerce Committee has put out a new white paper that seeks patient input on the development of patient registries, public-private partnerships, translational medicine and other areas of medical research and treatment development.” Click here to view the article.
3. PCORI, CQ HealthBeat, Bloomberg Comment On Annual Survey Of Comparative Effectiveness Research
Executive director of the Patient-Centered Research Institute (PCORI), Dr. Joe Selby, rendered a positive outcome from the survey conducted recently about comparative effectiveness research in the PCORI Blog. Dr. Selby comments, “[t]he National Pharmaceutical Council's annual survey on CER [...] asks more than 100 researchers, policy makers, employers, business groups, insurers, and health plans for their perspective on the research landscape... According to the NPC survey, in just three years, PCORI has gone from a supporting role to a key player in many areas of the research enterprise. One of those is setting research priorities. [...]The NPC survey results also recognize our growing role in supporting an active portfolio of research projects.” Click here to view the post.
John Reichard of CQ HealthBeat read the survey results with a broader lens than Dr. Selby, though he did recognize that PCORI was found to be a driving force in the field. Mr. Reichard reports, “[t]he survey was conducted by Scientific & Social Systems on behalf of the National Pharmaceutical Council...A total of 110 organizations including researchers, employers, trade groups and insurers were polled between Aug. 13, 2013 and Jan. 31, 2014. A full 84 percent of respondents said the research had little impact on health care decision making in the prior 12 months. However, 92 percent said they expect the research to have a moderate to substantial impact on health care decision making in the next five years.” Click here to view the article (subscription required).
Bloomberg also opined on the survey results, as Nathaniel Weixel reported, “[t]he [National Pharmaceutical Council] survey found confidence in CER's potential increased over time. Thirty-one percent of respondents said CER would have a ‘moderate improvement’ on health-care decision making over the next 12 months, which is unchanged from last year. Respondents said they were more confident about the impact of CER on health-care decision making over the next three to five years, with a ‘moderate improvement’ indicated by 56 percent and 50 percent, respectively, and a ‘substantial improvement’ indicated by 21 percent and 42 percent, respectively.” Click here to view the article (subscription required).
4. PCORI Blog: New Funding Announcement Advances Pragmatic Studies Initiative
Dr. David Hickam, Director of PCORI’s Clinical Effectiveness Research program, took to The PCORI Blog last week to tout February’s funding awards. Dr. Hickam wrote, “[o]ur first pragmatic studies funding announcement, published last February, generated a strong response from the research community. [...] The funding announcement for the second cycle adds to our previous list of 15 high-priority, high-burden topics of particular interest in this funding opportunity. The four new topics include treatment approaches for patients with end-stage renal disease and Crohn's disease, as well as interventions to reduce tobacco use and improving management of mental illness.” Click here to view the post.
5. Healthcare Informatics: While Big Data Promises Big Changes in Health Care, Hurdles Remain
Last Thursday, John DeGaspari of Healthcare Informatics reported on comments made by an executive of NEHI regarding patient-centered care and research. “‘Little if any of the CER research commissioned under the ACA has found its way into clinical findings and practice yet,’ [Thomas E. Hubbard, vice president of policy research at Network for Excellence in Health Innovation (NEHI)] said. ‘But this shifting landscape toward patient-centered research creates potential for new, innovative forms of patient care if these challenges can be met.’” Clickhere to view the article.
6. Harvard School of Public Health: Prevention in Public Health: What Works?
Amy Roeder reported on a Harvard School of Public Health forum held to discuss the state of CER and health care. “No other industry of the size and complexity of the U.S. health care system operates with so little understanding of the results of its investments, Dean Julio Frenk told an audience gathered May 15, 2014 at Harvard School of Public Health (HSPH) for a symposium on what works in health care. ‘That is why comparative effectiveness research is absolutely critical,’ he said [...] ‘We believe that public health interventions should be part of the comparative effectiveness agenda,’ said Milton Weinstein.” Click here for to view the review.
7. PCORI Blog: Planning for Dissemination and Use of Results from PCORI-Funded Research
Jean Slutsky and Orlando Gonzales of PCORI announced that, “[d]uring the next week, we will be using a crowd-sourcing tool to collect input from patients, caregivers, physicians, and nurses to advise us as we begin constructing our dissemination and implementation plan. With this tool, you can let us know how you identify useful healthcare information to help you make decisions. You can provide a new idea, vote on existing ideas, or suggest changes to existing ideas. [...] Our goal is to develop a Dissemination and Implementation Framework to identify the ways in which the research we fund can most effectively reach and influence those who make informed healthcare decisions.” Click here to view the post.
8. Wall Street Journal: The Bureaucrat Sitting on Your Doctor's Shoulder
In an op-ed for the Wall Street Journal, Zane F. Pollard commented that “[w]e all expect that doctors will do what is best for us according to their best judgment. This is part of the oath that doctors take when they graduate from medical school. When the government interferes with the doctor's right to select the treatment course and perform a necessary procedure, the integrity of the entire health-delivery system is compromised.” Click here to view the article.
9. The Hill, Politico: AHIP Comments On PCORI
Last week, Ferdous Al-Faruque of The Hill reported that “[t]he top health insurance lobbyist in the country says stakeholders are at a ‘crossroad’ on addressing the growing cost of specialty medications themselves before the government steps in...[Karen Ignani, president of America's Health Insurance Plans] said there are a few areas where government can step in to help reduce the cost of drugs, such as requiring comparative effectiveness research to help decide how much a medication is really worth.” Click here to view the full article.
Writing for Politico Pro, Brett Norman tackled the cost of Sovaldi, a new drug that drastically improves outcomes for hepatitis C patients, “[t]he astronomical price of a new “miracle” drug for hepatitis C has insurers and others who ultimately foot health care bills agreeing that drug costs are out of control and must come down. But there’s little consensus on how to make that happen. ‘We need to begin talking about how to attack this problem before the government has to,’ Ignagni said. Comparative effectiveness research, like that being spearheaded by the Obamacare-funded Patient Centered Outcomes Research Institute, could play a role, she said. But PCORI’s potential impact is undermined by a clause in its charter that forbids it from taking treatment costs into account, she added.” Click here to view the article (subscription required).
10. The Pink Sheet Daily: Part D Data-Sharing Expansion Stops Short Of Allowing Commercial Uses
Cathy Kelly of The Pink Sheet Daily reported on the potential junction of Big Data and CMS. “Some comments pointed out that CMS will face increasing pressure to release Part D data for commercial purposes in the context of Medicare's movement toward value-based payments as well as comparative effectiveness research using Medicare data.” Click here to view the article (subscription required).
11. Bloomberg: Most Doctors Prescribe Antibiotics That Don't Work
Commenting on a study published in the Journal of American Medicine Association, Bloomberg’s John Tozzi reported that “[t]he [JAMA] study shows how far evidence-based medicine has to go. The idea that doctors' decisions should be guided by rigorous trials into the effectiveness and safety of different therapies is a big part of what distinguishes modern medical care from earlier eras of bloodletting and leeches. All the sophisticated medical technology and pharmaceuticals developed in the past century won't help patients if they get the wrong treatment at the wrong time.” Click here to view the article.