Comparative Effectiveness Research: Promise or Peril?

    15 September 2008

    On September 15, 2008, Patton Boggs LLP and The Breaux Lott Leadership Group co-hosted a Forum on Comparative Effectiveness Research (CER) featuring a distinguished panel of experts, who offered their views on the potential impact of this critical policy debate on stakeholders in the health care sector, including manufacturers, providers, professionals and patients.

    Speakers included Liz Fowler, Chief Health Counsel for Senate Finance Chair Max Baucus (D-MT), Peter Orszag, Director of the Congressional Budget Office (CBO), Mark Miller, Executive Director of the Medicare Payment Advisory Commission (MedPAC), Marilyn Moon, Vice President at the American Institutes for Research, and Lu Zawistowich, Partner in the Health Care Practice Group at Patton Boggs LLP. Presentation slides from the forum are posted below.

    The panelists agreed that rapidly increasing health care costs are prompting policymakers to consider new tools to rein in spending, citing CER as the latest example. They noted that high spending is not leading to demonstrably better patient outcomes, which will drive consideration of systemic health care reforms next year.

    CBO Director Orszag emphasized that costs vary to a large extent based on geographic location, which may reflect a "that's what we do here" syndrome. He also questioned whether "open-ended" payment incentives for innovation are driving expenditures and suggested that changes are needed to ensure a sustainable system going forward.

    MedPAC Executive Director Miller indicated that research is often conducted in the private sector but not disseminated due to concerns about competitiveness and potential liability. MedPAC therefore envisions the creation of a new "skinny" entity to set the agenda for CER, standardize methodologies, develop ethical standards and share research findings.

    Dr. Moon underscored the need for better education to increase public acceptance of the use of CER findings in patient care, noting that some physicians fear they will receive a "cookbook" they must follow. Dr. Zawistowich addressed the practical challenges of implementing CER during the transition from a set of "measurements" to a set of "tools" that may be used to guide health reform efforts. She added that how CER is structured could affect both the level of transparency in decision-making and the level of input available to stakeholders.

    The forum concluded with a call to stakeholders to engage "early and often" in order to positively influence the outcome of this important health care policy debate. For more information, please contact Eugenia Edwards (; Tel. 202-457-5622).