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The PIPC Blog

PIPC Weekly Update - April 28, 2014

4/28/2014

 
In This Week’s Issue:
1. PCORI Seeks Comments on Evaluation Framework, click here for the full PCORI blog, and here to view PIPC’s recommendations.
2. Partnership to Fight Chronic Disease Says MedPAC Recommendations Miss the Mark, Cites PIPC Poll, click here to view the article.
3. The Pink Sheet Daily: Cancer Prices Make Comparative Effectiveness Trials Difficult, Researchers Say, click here for the full article (subscription required).
4. The Buffalo News: Doctors Shouldn't Be Forced to Make Treatment Decisions Based on the Cost, click here to view the op-ed.
5. WSJ: On the Road to Value-Based Care, are the Physician Reimbursement Data a Gold Mine? Click here to view the article.
6. Video: Privacy Concerns Abound for New National Medical Database, click here to view the video.
1. PCORI Seeks Comments on Evaluation Framework 
In a recent post on the PCORI Blog, Laura Forsythe, Victoria Szydlowski, Lori Frank, and Michele Orza, commented on building a framework for research: “In our effort to function as a learning organization, we pursue a wide range of evaluation activities." PIPC and others had provided input to PCORI related to the development of their evaluation framework, emphasizing that an important step in developing the brand “research done differently” is to better define, through its evaluation metrics, what makes PCORI truly different from other research organizations. This includes PCORI’s goals of patient engagement, the use of advisory panels to prioritize research, and the application of patient-centered criteria that must be included in all PCORI-funded research. This will give PCORI’s brand of  “research done differently” credibility.
​
PIPC is pleased that PCORI's draft evaluation framework recognizes the value of patient engagement and usefulness of information.  PIPC has consistently expressed concern that the broad funding announcement process inherently puts researchers in the position of driving the priorities and research agenda for PCORI, instead of PCORI focusing its research agenda on questions patients find important.  Therefore, we are feel that the draft evaluation framework should assess whether there was adequate patient and stakeholder involvement in Topic Generation and Research Prioritization (TGRP) in the broad funding announcement process.  PIPC also encourages PCORI to include stronger measures to evaluate whether making researchers accountable for including patients in the priority topic generation process is as effective as PCORI taking the lead in determining priority topics for research through engagement of stakeholders and the input of expert advisory panels. Click here to view the blog, here to view PIPC’s recommendations.

2. Partnership to Fight Chronic Disease Says MedPAC Recommendations Miss the Mark, Cites PIPC Poll

In an op-ed published in The Hill, Dr. Kenneth Thorpe of the Partnership to Fight Chronic Disease (PFCD) addressed concerns with the Medicare Payment Advisory Commission’s (MedPAC) discussion of applying "least costly alternative" or "comparative effectiveness" standards in Medicare policy.  Citing a recent poll from PIPC, Dr. Thorpe notes that patients  have overwhelmingly rejected proposals that would allow a government agency to determine which treatments were "best" based on "one size fits all" judgments. Dr. Thorpe comments, “In practice it puts Medicare policy in between doctors and patients and takes away doctors' ability to tailor care to the needs of each patient. Without the ability to tailor care to meet their individual patient's needs and preferences, doctors and hospitals must either prescribe the cheapest treatment or pass along the costs of a more appropriate treatment onto the patient… Maybe this could work in a world in which all human beings were identical in their body chemistry, genetic makeup, and health status, but in reality, our population is comprised of an infinite array of genetic and molecular combinations… By limiting coverage to treatments deemed to be the "least costly," these patients may face barriers and additional costs when seeking the combination of treatments that works best for them.” Click here to view the article.

3. The Pink Sheet Daily: Cancer Prices Make Comparative Effectiveness Trials Difficult, Researchers Say

Lisa LaMotta of The Pink Sheet Daily reported last week on barriers to cancer trials related to CER. She wrote, “‘High prices preclude independent comparative effectiveness trials that would seek to establish equally effective but cheaper alternatives – thereby protecting the market share of expensive drugs,’ Sham Mailankody of the National Cancer Institute and Vinay Prasad, Ohio State University, remarked...Conducting randomized non-inferiority trials comparing drugs that are similar biologically but differ in cost could allow physicians to make more economical choices regarding a patient's treatment, the authors said. Yet, these types of trials are not in the best interest of drug companies that could lose market share if their products do not prove superior.” Click here to view the article (subscription required).

4. The Buffalo News: Doctors Shouldn't Be Forced to Make Treatment Decisions Based on the Cost

Last week The Buffalo News posted an op-ed related to recent concerns about CER and overall health care payment policies. "Comparative effectiveness research looks at different therapies scientifically and publicly reports which types of care work best in particular cases. Unfortunately, unlike the British system, it is illegal for federally funded comparative effectiveness research to even consider whether a treatment is more cost-effective. We should not spend hundreds of millions of taxpayer dollars a year on a system that cannot even analyze what types of care provide higher value.” Click here to view the op-ed.

5. WSJ: On the Road to Value-Based Care, are the Physician Reimbursement Data a Gold Mine?

Analysis from Sarah Thomas of Deloitte looks into PCORI and the recent release from CMS of Medicare reimbursement data. “I am sure that physicians believe they are providing high-quality care to their patients. But to me, the variation in reimbursement points out that health care could benefit from an independent and rigorous analysis of which drugs work best and for which patients, and which treatments offer the best value (both in cost and efficacy). This was the promise with a comparative effectiveness agenda and the creation of the Patient-Centered Outcomes Research Institute (PCORI) in the Affordable Care Act (ACA).” Click here to view the article.

6. Video: Privacy Concerns Abound for New National Medical Database

Matt Stewart, reporting from a Fox affiliate in Kansas City, put voice to concerns over PCORnet. “Because many hackers target medical records, [John Carney, CEO of the Kansas City-based Center for Practical Bioethics] wants to make sure a patient's medical information stored in this database is not able to be traced back to that person. PCORI promises there will be no personal information connecting a specific person to a specific medical record. They simply plan on collecting the raw data for research purposes.” Click here to view the video.

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