Comparing Health Care Effectiveness

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In our current health care system, physicians, insurers, and patients must often choose between several treatments without knowing which works better or whether the higher-priced treatment provides added value. Research that evaluates the effectiveness of two or more prevention, diagnosis, or treatment options—known as comparative effectiveness research, or CER—can address this evidence gap. Funding for CER was an important feature of the Affordable Care Act because this research has the potential to lower health care costs over the long term while maintaining or improving the quality of care, according to the independent Congressional Budget Office, or CBO.

The Affordable Care Act created a new independent nonprofit, the Patient-Centered Outcomes Research Institute, or PCORI, to fund and disseminate CER. Our analysis finds that four years into its 10-year existence, the institute has dedicated less than 40 percent of its research funding to CER. Moreover, PCORI has not initiated a single CER study of medical devices, launched only a few CER studies of drugs, and produced only a handful of analyses that synthesize existing CER studies. Few studies focus on the priority areas identified by the Institute of Medicine, or IOM.

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