AMCP voices support for a national inventory of comparative effectiveness research

The Academy of Managed Care Pharmacy (AMCP) has responded to a request from the Office of the Assistant Secretary for Planning and Evaluation (ASPE) in the Department of Health and Human Services (HHS). In this request, ASPE indicates that it is developing a national inventory of comparative effectiveness research (CER) and CER-related information driven by the American Recovery and Reinvestment Act, signed into law by President Obama in 2009. ASPE indicates that the process of cataloguing CER and infrastructure will be critical to tracking ongoing and future investments in CER.

AMCP agrees that such an inventory will be a valuable resource.

According to a letter dated July 30, AMCP made the following points:

Who will use the inventory - Comparative effectiveness research compares clinical outcomes or effectiveness of alternative therapies for the same condition. Physicians; pharmacists; other health professionals; purchasers of healthcare, including employers, health plans, and government; and patients need objective, easily-accessible, evidence-based information regarding the comparative effectiveness and value of healthcare resources and services in order to make knowledgeable and informed decisions.

Clinicians and patients require this information in order to evaluate treatment options and select the one most likely to achieve a desired therapeutic outcome. For managed care pharmacy, entities that pay for prescription drug benefits require this information so they can design a benefit that ensures that patients receive the best value for the resources expended. More evidence on which treatments work best and which do not work as well will lead to better healthcare decisions and improved quality of care.

What Should Be Included- As vital as clinical data are to the success of comparative effectiveness research, AMCP believes it is as essential that the cost effectiveness of treatments not be precluded as a component of overall research. AMCP’s members use various tools and strategies, including the cost effectiveness of treatments, as a means of combating the increasingly high cost of healthcare. It is vital that research on cost-effectiveness research be included in an inventory of CER. AMCP strongly recommends that cost effectiveness of treatments be included in the definition of CER for the purposes of identifying research to be included in the national inventory.

How the Inventory Should be Structured - AMCP agrees with ASPE that an important component necessary for the effective use of CER is creating an inventory to ensure that patients, clinicians, and other decision-makers can locate and easily make use of relevant CER in a timely manner. Most importantly, for the inventory to be of use to clinicians, patients, and other healthcare decision-makers, it must be organized and presented in a user-friendly, easily searchable tool.

Two important questions that will need to be decided is what types of studies are to be included (published, peer-reviewed articles vs non-published studies) and what criteria will be required for inclusion in the database (eg, minimum scientific integrity, relevance to healthcare decision-making), the letter said.