Comparative research lags far behind approval-driven evaluations

A new study has found that few drug evaluations compare treatments in ways that help doctors make better decisions, Reuters reports. The study, published in today's Journal of the American Medical Association and written by doctors from Harvard and University of Southern California, also found that private firms - the main sponsors of research that compare drugs to placebos - have little interest in drug-to-drug comparisons, and that even when researchers do compare drugs, they often fail to answer questions about safety and improving effectiveness (Fox, 3/9).

The Boston Globe adds, "two-thirds of the 328 studies [evaluated for the paper] compared a drug to unapproved, so unavailable, drugs or to inactive substances called placebos." One author of the study said, "Those are not particularly helpful for physicians and patients who are sitting down and figuring out what's the best treatment available for a given condition" (Cooney, 3/9).

By contrast, "[j]ust 11% of comparative-effectiveness studies compared drugs with nonpharmacologic therapies such as lifestyle changes; 19% compared medication safety; and 2% included cost-effectiveness analysis…" Modern Healthcare reports. "The authors also found that drugmakers funded very little of the existing comparative-effectiveness research. Nearly 90% of such studies were funded by noncommercial institutions such as not-for-profit foundations or government agencies" (Rhea, 3/9).

"Why do so few drug studies involve available medicines?" HealthDay News/BusinessWeek asks. "According to the authors, most such trials are funded by pharmaceutical companies, which are more interested in getting new, marketable products on drugstore shelves." Another author of the study said, "If we hope to increase the amount and improve the quality of comparative effectiveness studies, the funding will most likely need to come from government institutions" (Mundell, 3/9).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.