New Democrat coalition proposes independent panel to oversee comparative effectiveness research

Members of the moderate New Democrat Coalition on Tuesday proposed legislation (HR 2502) that would establish a non-governmental, independent office to oversee research efforts to compare the effectiveness of medical treatments, CQ HealthBeat reports.

The bill would create the Health Care Comparative Effectiveness Research Institute, which would use money remaining from the $1.1 billion included in the economic stimulus package for comparative effectiveness research and additional funding from fees on Medicare and private insurers. HCCERI would be overseen by a 21-member board -- appointed by the U.S. Comptroller General -- that would include HHS officials, patients, physicians, private insurers and others (Norman, CQ HealthBeat, 5/19).

In contrast, a panel to oversee comparative effectiveness research established by a provision in the stimulus bill would be made up of government health experts (Mundy, "Washington Wire," Wall Street Journal, 5/19). According to CQ HealthBeat, some people have raised concerns that comparative effectiveness research funded by the stimulus bill would result in research that could be used to deny coverage for certain treatments and that cost would factor disproportionately in such decisions.

Rep. Kurt Schrader (D-Ore.), who introduced the bill, said HCCERI's goal would be to ensure that medical decisions remain between physicians and patients and that both doctors and patients have the most understandable information possible to make such decisions. HCCERI also would make public its methods for deciding which research projects to approve, as well as any links the institute has to industry, its research protocols and the names of researchers. HCCERI would accept public comment before creating new research guidelines, and all research would be subject to peer review. In addition, HCCERI in commissioning studies would take steps to account for differences in patients' gender, race, age and ethnicity (CQ HealthBeat, 5/19).

Schrader said that the bill "will bring patients, along with health care providers, physicians and industry, to the decision-making process," adding, "By having a seat at the table, the American people will help drive the direction of research based on what is most important to them" ("Washington Wire," Wall Street Journal, 5/19). Rep. Allyson Schwartz (D-Pa.) said that New Democrats seek to lower costs and improve quality of care, so "the most important thing we can do is to incentivize innovation and to provide that information on the best practices and best interventions and get that information out to providers."

Industry Reaction

Tony Coelho -- chair of the Partnership To Improve Patient Care, which represents patients, physicians, advocacy groups and industry members such as the Pharmaceutical Research and Manufacturers of America -- endorsed the legislation but said that comparative effectiveness research could potentially restrict patients' ability to choose between different treatments. He added, "My concern as a patient is that cost containment will become the main goal" (CQ HealthBeat, 5/19). Merck also released a statement in support of the bill. However, Voices for Physicians, a group affiliated with the Center for American Progress, said physicians must be able to access comparative effectiveness information that has not been influenced by the drug, hospital or insurance industries ("Washington Wire," Wall Street Journal, 5/19). Schrader said that HCCERI would employ strict guidelines to curb conflicts of interest and industry bias (CQ HealthBeat, 5/19).