Comparative effectiveness research: Industry need to weigh its benefits
In the provider settings, the CER outcomes based on the analysis of the controlled clinical trials, patient registries, observational studies, clinical and claims records can hugely contribute towards correct clinical decision making, rapid identification and dissemination of therapeutic standards, case specific device usage decision, prioritization of therapies based on patient clinical profiles, and identification of high-risk patients for accurate triaging and required intervention. Not only that, historically when the providers have largely relied on their physician/surgeon preferences as the primary means to drive any new drug/device uptake (irrespective of cost and clinical outcomes), CER now can be the decisive tool to have them back on the heels, fighting vigorously against this traditional approach, and set a new direction for inclusion of cost-to-outcomes comparisons for effective purchasing decisions.
May be the concept of CER seems to be more providers centric, and industry might think that there is very less for the health plans in the CER adoption. But in my opinion, payers too have a list of benefits to derive from this. Upfront, CER can help to build an accepted framework for the evaluation of cost-effectiveness and clinical benefits of new pharmaceutical products and medical devices so as to fine tune the medical policies and coverage decisions of their members. But, this may not be the CER limit in the payer space. Obviously, payers can also leverage this powerful analytical tool to rationalize their utilization reviews, premium pricing, provider credentialing, quality monitoring, and medical management programs to derive their best business outcomes.
Even, with all the worries among the pharmaceutical companies and devices manufacturers e.g. cheap off-patent versions might take over the new patent drugs, the obsolete devices will now project the imperceptible treatment benefits, CER still hold promises to set a unique opportunities for them in establishing a value-realized system to build their products with more focused innovations.
Apparently, all these might sound as an ability of CER to bring down the cost of care and limit a physician's autonomy towards clinical judgment. But I strongly feel that, CER being an evidence centric analytic tool can never be so short-sighted, rather it will consistently keep injecting the value of scientific investigation in promoting the nation's healthcare by delivering the right treatment to the right patient at the right time. So, Industry just need to understand the value of CER and realize the incentives to invest in it.
