In This Week’s Issue:
1. JAMA Forum: Time to Hit the Pause Button on Medicare’s Payment Demonstration Projects?, click here to view the article.
2. Medical Ethics: Incontinence A Fate Worse Than Death? Really?, click here to view the article.
3. Scoping Document for ICER Review of Abuse-Deterrent Opioid Formulations Open for Public Comment, click here to view the announcement.
4. PCORI Call for Research Questions: Help Identify Opportunities to Improve Care for Cardiovascular Diseases, click here to view the blog post.
5. PCORI to Re-Open Multiple Sclerosis Funding Announcement, click here to view the pre-funding announcement.
6. Medical Journal Articles, see details below.
7. Upcoming Events and Webinars, see details below.
8. AHRQ Effective Program Updates, see details below.
1. JAMA Forum: Time to Hit the Pause Button on Medicare’s Payment Demonstration Projects?, click here to view the article.
2. Medical Ethics: Incontinence A Fate Worse Than Death? Really?, click here to view the article.
3. Scoping Document for ICER Review of Abuse-Deterrent Opioid Formulations Open for Public Comment, click here to view the announcement.
4. PCORI Call for Research Questions: Help Identify Opportunities to Improve Care for Cardiovascular Diseases, click here to view the blog post.
5. PCORI to Re-Open Multiple Sclerosis Funding Announcement, click here to view the pre-funding announcement.
6. Medical Journal Articles, see details below.
7. Upcoming Events and Webinars, see details below.
8. AHRQ Effective Program Updates, see details below.
1. JAMA Forum: Time to Hit the Pause Button on Medicare’s Payment Demonstration Projects?
Gail Wilensky, PhD, a former CMS official and Senior Fellow at Project HOPE, discusses CMMI’s demonstrations in a recent JAMA op-ed. “After a slow start in 2011, the Center for Medicare & Medicaid Innovation (CMMI) at the Centers of Medicare & Medicaid Services (CMS) seems to have gone into overdrive. As part of the Department of Health and Human Services’ pledge to move the majority of Medicare payments away from undifferentiated fee-for-service payments to some type of value-based care, CMMI has been sponsoring a wide variety of models. These include models that feature fee-for-service payments with incentives added, bundled or episode-based payments, and population-based payments… Pilot projects can be useful. Most frequently, they seem to show what strategies don’t work, but even this apparent failure may instead reflect the unwillingness of the affected parties to change their behavior for an institutional change that they doubt will be permanent… In January, a new administration will be in place… After appropriate consultation, the administration should make the best decisions it can about the next generation of Medicare reimbursement. Modifications can and will be made in the future, just as they have been in the past. Enough demonstrations, already.” Click here to view the article.
2. Medical Ethics: Incontinence A Fate Worse Than Death? Really?
A recent article in Common Health underscores concerns from people with disabilities about how we measure health care value and quality. As recently reported, “In a recent survey, Dr. Emily Rubin and colleagues from the University of Pennsylvania asked 180 hospitalized patients over age 60 which ‘states of functional debility’ might be so awful as to make death preferable… Incontinence was considered the same as or worse than death by 68.9 percent of those surveyed -- the highest among the 10 states of debility. My response: Seriously? Incontinence is the ultimate fate worse than death? I’ve changed lots of diapers. Granted, they didn’t belong to elderly adults. But still. What is behind this? Most likely, I think, it is a question of dignity. Dignity might be the most widely used but poorly understood word in end-of-life ethics. It is as individual as ‘quality of life.’ … I strongly suspect that many survey respondents saw incontinence as worse than death not because of the indignity itself but rather because of their concern about becoming a burden. No one wants to be a burden. But living with some level of disability is so common that it's important not to catastrophize it… With her recent survey, Rubin has done important work in clarifying patient values about debilitating illness. But there is a big difference between an imagined disability and a real one. And if care is attentive and compassionate, a management issue should not be a fate worse than death.” Click here to view the article.
3. Scoping Document for ICER Review of Abuse-Deterrent Opioid Formulations Open for Public Comment
The Institute for Clinical and Economic Review (ICER) has posted a draft scoping document that will shape an upcoming report on abuse-deterrent opioids. According to a press release, “ICER's report will review the evidence on several new and emerging opioid re-formulations to evaluate how effectively these drugs reduce opioid misuse and its many consequences. Analyses will also be performed to provide information on the long-term value of abuse-deterrent opioids for the health system and for society. The draft scoping document will be open to public comment for three weeks until Wednesday, September 28, 2016 at 5pm ET.” Click here to view the announcement.
4. PCORI Call for Research Questions: Help Identify Opportunities to Improve Care for Cardiovascular Diseases
Last week PCORI and the American Heart Association (AHA) announced a crowdsourcing challenge for clinicians and researchers across the country. As detailed in a blog post, “Proposed hypotheses should focus on questions that can be answered by comparative clinical effectiveness research (CER), which compares the benefits and risks of alternate healthcare methods. Submissions should use a precision medicine approach, which takes into account individual patients' genetics, environmental factors, lifestyle, and other characteristics.” Click here to view the blog post.
5. PCORI to Re-Open Multiple Sclerosis Funding Announcement
The Patient-Centered Outcomes Research Institute (PCORI) will be re-opening the targeted funding announcement, Treatment of Multiple Sclerosis, through which PCORI seeks to fund randomized clinical trials or observational studies that compare two or more alternatives for the treatment of multiple sclerosis, with a focus on the effects of therapies on the symptoms experienced by patients with MS and on quality of life and functional status. The three topics of this funding announcement include comparisons of the effects of disease-modifying therapies (DMTs) and DMT-based strategies; of non-DMT therapies aimed at specific symptoms; and of telerehabilitation versus conventional direct care on functional status, fatigue, and quality of life. The full funding announcement will be released on October 4, 2016. Click here to view the pre-funding announcement.
6. Medical Journal Articles
Comparative Analysis of Persistence to Treatment Among Patients with Asthma or COPD Receiving AirFluSal Forspiro or Seretide Diskus Salmeterol/Fluticasone Propionate Combination Therapy, click here to view.
Evidence-Based Medicine: A Genealogy of the Dominant Science of Medical Education, click here to view.
The Evidence-Based Transformation of American Medicine, click here to view.
The Correlation Between HTA Recommendations and Reimbursement Status of Orphan Drugs in Europe, click here to view.
Infliximab Versus Ciclosporin for Steroid-Resistant Acute Severe Ulcerative Colitis (CONSTRUCT): A Mixed Methods, Open-Label, Pragmatic Randomised Trial, click here to view.
Big Data: Transforming Drug Development and Health Policy Decision Making, click here to view.
Probabilistic Bias Analysis in Pharmacoepidemiology and Comparative Effectiveness Research: A Systematic Review, click here to view.
Comparative Efficacy and Safety of First-Line Antiretroviral Therapy for the Treatment of HIV Infection: A Systematic Review and Network Meta-Analysis, click here to view.
7. Upcoming Events and Webinars
AHCJ Fellowship on Comparative Effectiveness Research
September 11-15, 2016
Click here for details.
Getting to Know PCORI: From Application to Closeout (September 2016)
September 20, 2016, 9:00AM - 5:00PM EDT
Click here for details.
PCORI Board of Governors Meeting
September 27, 2016, 12:00PM - 1:30PM EDT
Click here for details.
Assessing Value: Promise & Pitfalls
September 29, 2016
Click here for details.
LAN Webinar: Building a Robust Data Infrastructure that Supports APMs
October 5, 2016, 2:00PM ET
Click here for details.
PCORI: Advisory Panel on Addressing Disparities Fall 2016 Meeting
October 24, 2016, 9:00AM - 5:00PM ET
Click here for details.
Recommendations of the Second Panel on Cost-Effectiveness in Health and Medicine
December 7, 2016, 9:00AM - 4:30PM
Click here for details.
8. AHRQ Effective Program Updates
Identification and Treatment of Post-Acute Coronary Syndrome (ACS) Depression: A Systematic Review -- Research Protocol, click here to view.
Transparency of Reporting Requirements - Project Overview, click here to view.
Gail Wilensky, PhD, a former CMS official and Senior Fellow at Project HOPE, discusses CMMI’s demonstrations in a recent JAMA op-ed. “After a slow start in 2011, the Center for Medicare & Medicaid Innovation (CMMI) at the Centers of Medicare & Medicaid Services (CMS) seems to have gone into overdrive. As part of the Department of Health and Human Services’ pledge to move the majority of Medicare payments away from undifferentiated fee-for-service payments to some type of value-based care, CMMI has been sponsoring a wide variety of models. These include models that feature fee-for-service payments with incentives added, bundled or episode-based payments, and population-based payments… Pilot projects can be useful. Most frequently, they seem to show what strategies don’t work, but even this apparent failure may instead reflect the unwillingness of the affected parties to change their behavior for an institutional change that they doubt will be permanent… In January, a new administration will be in place… After appropriate consultation, the administration should make the best decisions it can about the next generation of Medicare reimbursement. Modifications can and will be made in the future, just as they have been in the past. Enough demonstrations, already.” Click here to view the article.
2. Medical Ethics: Incontinence A Fate Worse Than Death? Really?
A recent article in Common Health underscores concerns from people with disabilities about how we measure health care value and quality. As recently reported, “In a recent survey, Dr. Emily Rubin and colleagues from the University of Pennsylvania asked 180 hospitalized patients over age 60 which ‘states of functional debility’ might be so awful as to make death preferable… Incontinence was considered the same as or worse than death by 68.9 percent of those surveyed -- the highest among the 10 states of debility. My response: Seriously? Incontinence is the ultimate fate worse than death? I’ve changed lots of diapers. Granted, they didn’t belong to elderly adults. But still. What is behind this? Most likely, I think, it is a question of dignity. Dignity might be the most widely used but poorly understood word in end-of-life ethics. It is as individual as ‘quality of life.’ … I strongly suspect that many survey respondents saw incontinence as worse than death not because of the indignity itself but rather because of their concern about becoming a burden. No one wants to be a burden. But living with some level of disability is so common that it's important not to catastrophize it… With her recent survey, Rubin has done important work in clarifying patient values about debilitating illness. But there is a big difference between an imagined disability and a real one. And if care is attentive and compassionate, a management issue should not be a fate worse than death.” Click here to view the article.
3. Scoping Document for ICER Review of Abuse-Deterrent Opioid Formulations Open for Public Comment
The Institute for Clinical and Economic Review (ICER) has posted a draft scoping document that will shape an upcoming report on abuse-deterrent opioids. According to a press release, “ICER's report will review the evidence on several new and emerging opioid re-formulations to evaluate how effectively these drugs reduce opioid misuse and its many consequences. Analyses will also be performed to provide information on the long-term value of abuse-deterrent opioids for the health system and for society. The draft scoping document will be open to public comment for three weeks until Wednesday, September 28, 2016 at 5pm ET.” Click here to view the announcement.
4. PCORI Call for Research Questions: Help Identify Opportunities to Improve Care for Cardiovascular Diseases
Last week PCORI and the American Heart Association (AHA) announced a crowdsourcing challenge for clinicians and researchers across the country. As detailed in a blog post, “Proposed hypotheses should focus on questions that can be answered by comparative clinical effectiveness research (CER), which compares the benefits and risks of alternate healthcare methods. Submissions should use a precision medicine approach, which takes into account individual patients' genetics, environmental factors, lifestyle, and other characteristics.” Click here to view the blog post.
5. PCORI to Re-Open Multiple Sclerosis Funding Announcement
The Patient-Centered Outcomes Research Institute (PCORI) will be re-opening the targeted funding announcement, Treatment of Multiple Sclerosis, through which PCORI seeks to fund randomized clinical trials or observational studies that compare two or more alternatives for the treatment of multiple sclerosis, with a focus on the effects of therapies on the symptoms experienced by patients with MS and on quality of life and functional status. The three topics of this funding announcement include comparisons of the effects of disease-modifying therapies (DMTs) and DMT-based strategies; of non-DMT therapies aimed at specific symptoms; and of telerehabilitation versus conventional direct care on functional status, fatigue, and quality of life. The full funding announcement will be released on October 4, 2016. Click here to view the pre-funding announcement.
6. Medical Journal Articles
Comparative Analysis of Persistence to Treatment Among Patients with Asthma or COPD Receiving AirFluSal Forspiro or Seretide Diskus Salmeterol/Fluticasone Propionate Combination Therapy, click here to view.
Evidence-Based Medicine: A Genealogy of the Dominant Science of Medical Education, click here to view.
The Evidence-Based Transformation of American Medicine, click here to view.
The Correlation Between HTA Recommendations and Reimbursement Status of Orphan Drugs in Europe, click here to view.
Infliximab Versus Ciclosporin for Steroid-Resistant Acute Severe Ulcerative Colitis (CONSTRUCT): A Mixed Methods, Open-Label, Pragmatic Randomised Trial, click here to view.
Big Data: Transforming Drug Development and Health Policy Decision Making, click here to view.
Probabilistic Bias Analysis in Pharmacoepidemiology and Comparative Effectiveness Research: A Systematic Review, click here to view.
Comparative Efficacy and Safety of First-Line Antiretroviral Therapy for the Treatment of HIV Infection: A Systematic Review and Network Meta-Analysis, click here to view.
7. Upcoming Events and Webinars
AHCJ Fellowship on Comparative Effectiveness Research
September 11-15, 2016
Click here for details.
Getting to Know PCORI: From Application to Closeout (September 2016)
September 20, 2016, 9:00AM - 5:00PM EDT
Click here for details.
PCORI Board of Governors Meeting
September 27, 2016, 12:00PM - 1:30PM EDT
Click here for details.
Assessing Value: Promise & Pitfalls
September 29, 2016
Click here for details.
LAN Webinar: Building a Robust Data Infrastructure that Supports APMs
October 5, 2016, 2:00PM ET
Click here for details.
PCORI: Advisory Panel on Addressing Disparities Fall 2016 Meeting
October 24, 2016, 9:00AM - 5:00PM ET
Click here for details.
Recommendations of the Second Panel on Cost-Effectiveness in Health and Medicine
December 7, 2016, 9:00AM - 4:30PM
Click here for details.
8. AHRQ Effective Program Updates
Identification and Treatment of Post-Acute Coronary Syndrome (ACS) Depression: A Systematic Review -- Research Protocol, click here to view.
Transparency of Reporting Requirements - Project Overview, click here to view.
