JANUARY 10, 2012

Welcome to the Comparative Effectiveness Update eNewsletter
This issue is sponsored by the Pay for Performance Summit

Comparative Effectiveness Research Grants Attract Strong Interest
The Patient-Centered Outcomes Research Institute has received more than 20 applications for each pilot project grant it is offering to groups that help the organization develop priorities and methods for researching the effectiveness of medical care. PCORI received 856 requests for its Pilot Project Grant Program, its first major funding opportunity. The institute will select approximately 40 awardees by the end of March, each of whom will receive a share of $26 million in pilot grant funding over two years. (amednews.com, December 16, 2011)

GOP Steps Up Attack on Comparative Effectiveness Institute
Late Tuesday the Republican Policy Committee mounted an attack on the health care reform's comparative effectiveness research program, calling it a tax on the middle class to fund research that "could be used to justify placing limits on costly medical treatments." The move appears to warrant the concerns of comparative effectiveness research supporters who worry it will be engulfed - again - by the political rhetoric of health care rationing and "death panels." (Politico Pro, January 3, 2012 - Paid Subscription Required)

ECRI Institute Issues 2012 Technology Watch List for Hospital Execs
ECRI Institute, an independent nonprofit that researches the best approaches to improving patient care, has listed 10 health technology issues that hospital leaders should have on their watch lists for 2012. This year's top 10 C-Suite watch list includes: Electronic health records; Transcatheter heart valve Implantation; Digital breast tomosynthesis; New CT radiation reduction technologies; Transcatheter heart valve implantation; Robotic-assisted surgery; New cardiac stent developments; Ultrahigh-field-strength MRI systems; Proton beam radiation therapy; and Personalized therapeutic vaccines for cancer. (healthcareitnews.com, January 3, 2012)

GOP Hits New Fee on Health Plans
Republicans on Tuesday attacked a new fee under the healthcare reform law, that is set to take effect this week for many consumers, has come under scrutiny from republicans who have contrasted the fee with Obama's opposition, during the 2008 campaign, to taxing employer-based health benefits. The healthcare law tacks on a fee of $1 per year to private insurance plans. The money will fund comparative effectiveness research - studies into which treatments work best for particular conditions. (The Hill, January 3, 2012)

ACP Makes Close Watch on Costs an Ethical Issue
A new ethics manual from the American College of Physicians (ACP) recommends that physicians practice "parsimonious" care. The manual, published as a supplement to the Jan. 3 issue of Annals of Internal Medicine, noted that a physician's first duty is always to the patient, but added, "Physicians have a responsibility to practice effective and efficient health care, and to use health care resources responsibly. Parsimonious care that utilizes the most efficient means to effectively diagnose a condition and treat a patient respects the need to use resources wisely and to help ensure that resources are equitably available." (MedPage Today, January 3, 2012)

CMS Picks 73 for Innovation Advisors Program
The CMS has chosen 73 healthcare professionals from a pool of more than 900 applications for the agency's Innovation Advisors Program, an initiative in which trained leaders will test new delivery models in their organizations and communities. The advisers come from 27 states and Washington, D.C., and compose a group that includes clinicians, allied health professionals and health administrators. They will participate in an orientation program and then work with the CMS Innovation Center to test new care models aimed at improving quality and lowering costs. (Modern Healthcare, January 3, 2012)

AHRQ Studies How to Get Public Involved in Guiding Comparative Effectiveness Research
The Agency for Healthcare Research and Quality is researching methods to get the public involved in deciding how comparative effectiveness research should be used in health care decisions, sparking mixed stakeholder response. Concern that the effort could end up limiting access to tests and treatments, especially expensive ones, has been voiced by the Personalized Medicine Coalition Concern but the Center for Medical Technology Policy says AHRQ is merely implementing part of a year-old project to involve end users of research in forming research questions and using the results. (insidehealthpolicy.com, December 29, 2011 - Paid Subscription Required)

New Fee Coming for Medical Effectiveness Research
Starting in 2012, the government will charge a new fee to your health insurance plan for research to find out which drugs, medical procedures, tests and treatments work best. The insurance fee could be branded a tax and drawn into the vortex of election-year politics. The $1-per-person insurance fee goes into effect in 2012. But the Treasury Department says it's not likely to be collected for another year, though insurers would still owe the money. The fee doubles to $2 per covered person in its second year and thereafter rises with inflation. (Boston Herald, December 27, 2011)

Newt Gingrich vs. Newt Gingrich on Comparative Effectiveness Research
Peter Sudeman examines Newt Gingrich's flip-floping on comparative effectiveness research over the years. Gingrich and his health care consultancy, the Center for Health Transformation, supported and praised comparative effectiveness research right up until he decided that it was a dehumanizing bureaucratic plot. (reason.com, December 16, 2011)

Executive Director's Corner
The Patient-Centered Outcomes Research Institute's mission is not only to fund comparative clinical effectiveness research, but to create widely accepted standards for how this research should be conducted to provide the greatest benefit to patients and those who care for them. The law establishing PCORI specifically called for the creation of a Methodology Committee that "shall work to develop and improve the science and methods of comparative clinical effectiveness research." (pcori.org, January 5, 2012)

CER Interview with Dan Ollendorf

Dan Ollendorf, MPH, ARM , is Chief Review Officer for the Institute of Clinical and Economic Review (ICER); in this capacity, he is responsible for the conduct of systematic reviews of the comparative effectiveness of new or emerging health care technologies, as well as the coordination and oversight of the broader health technology assessment process. Dan's 25 years of health care experience include work in the insurance, managed care, hospital, informatics, and consulting sectors, the last 15 years of which have been spent conducting health-economic, epidemiologic, and other relevant evaluations for a variety of stakeholders. (agingresearch.org, January 4, 2012)

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The Role of NIH in Comparative Effectiveness Research

Michael S. Lauer, MD, FACC, FAHA
Director, NHLBI/Division of Cardiovascular Sciences, Bethesda, MD