HHS announces plans for research on specific medical conditions

The Agency for Healthcare Research and Quality published a notice in the Federal Register on Wednesday detailing its plans to release grant and contract solicitations this fall to evaluate treatments for 14 priority health conditions relevant to Medicare, Medicaid and the State Children's Health Insurance Program.

The medical conditions include arthritis; cancer; heart disease; dementia; depression; developmental delays, such as attention-deficit hyperactivity disorder and autism; diabetes; functional limitations and physical disabilities; infectious diseases, including HIV/AIDS; obesity; digestive system conditions; pregnancy and childbirth; asthma; and substance abuse.

The research will be funded from $1.1 billion appropriated by Congress for comparative effectiveness research under the 2009 American Recovery and Reinvestment Act. Such research is aimed at providing information on the relative strengths and weaknesses of various medical interventions, thus arming clinicians and patients with valid data that will help them make better health care decisions, according to a program description by the Health and Human Services Department.

Government researchers estimate Americans waste $700 billion annually on medical treatments of dubious value. Clearly, there is a need to develop and disseminate reliable data that provide objective comparisons of various health treatments and their outcomes. But what seems like a straightforward need has become a political football in the ongoing debate over health care reform.

"Conservatives warn that a federal comparative-effectiveness agency would lead to government rationing of medical care -- indeed, that's the whole idea," said Michael F. Cannon, director of health policy studies at the Cato Institute, a libertarian think tank in Washington. Cannon supports such research; he just thinks the private sector should do it, a position he detailed in a report in February.

"If history is any guide, the more likely outcome is that the agency would be completely ineffective: political pressure from the industry will prevent the agency from conducting useful research and prevent purchasers from using such research to eliminate low-value care," Cannon said.

A number of key Republicans have lobbied against comparative effectiveness research funding because they believe it will result in government bureaucrats making health decisions better left to individuals and their doctors. In late July, House Minority Leader John Boehner, R-Ohio, introduced legislation that would prohibit the use of data collected from comparative effectiveness research to deny coverage of items or services under federal healthcare programs.

Consumers Union, the nonprofit publisher of Consumer Reports, supports the Recovery Act spending on comparative effectiveness research on the grounds that such research is a critical component of health care reform as it will give patients and providers better information, thereby improving the quality of care while limiting unnecessary costs.

Such research has the potential to encourage insurers to make coverage decisions based on the evidence for effectiveness rather than costs, and could reduce disparities in care often experienced by racial, ethnic and low-income groups. "Right now in our nation, we simply know more about which toasters work best than which drugs or surgical techniques work best," the group said in a statement.