January 8, 2010
The Honorable Nancy Pelosi
United States House of Representatives
Washington, DC 20515
Dear Speaker Pelosi:
Thank you for your tireless efforts to expand quality, affordable health care coverage to millions of Americans. In merging the House and Senate health care bills, members of the Patient and Consumer Coalition strongly urge you to include the House language on comparative effectiveness research.
The Senate language proposes the establishment of a non-profit “Patient-Centered Outcomes Research Institute,” and requires that the Governing Board include several members representing “pharmaceutical, device, and diagnostic manufacturers or developers.”
In a recent New England Journal of Medicine (NEJM ) article entitled, “Industry Influence on Comparative-Effectiveness Research Funded through Health Care Reform,” well-respected health policy experts Dr. Harry Selker and Dr. Alastair Wood noted that “Embedded in the Senate legislation are provisions ceding substantial influence to the medical products industries that have a major interest in the outcomes of such research.”
By proposing that the center for comparative effectiveness research be within the Agency for Healthcare Research and Quality (AHRQ), the House language avoids industry conflict-of-interest. AHRQ is well-established and well-respected, and comparative effectiveness research is consistent with AHRQ’s mission of improving “the quality, safety, efficiency and effectiveness of health care for all Americans.” The House language allows comparative effectiveness research to be done scientifically and objectively. Comparative effectiveness research done in this manner should save lives and improve medical care by reducing the use of ineffective treatments, including pharmaceuticals, medical devices, and inaccurate, unreliable, or potentially dangerous medical tests.
We realize that AHRQ has received some criticism for guidelines proposed by the U.S. Preventive Services Task Force. We want to point out that the Task Force is an independent entity and is not comprised of AHRQ employees, nor does AHRQ control their guidelines or how those guidelines are communicated. Whether you admire the Task Force for their work over the years or criticize them for their conclusions or communication skills, is irrelevant to the issue of whether AHRQ should be the entity entrusted with comparative effectiveness research. Clearly, AHRQ has the expertise and objectivity needed for the comparative effectiveness research that will provide patients and healthcare providers with the information they need to make the best possible medical decisions.
Objective comparative effectiveness research is urgently needed. In 2009, an Institute of Medicine report on the topic stated: “All too often, the information necessary to inform…medical decisions is incomplete or unavailable, resulting in more than half of the treatments delivered today without clear evidence of effectiveness.”
The goal of comparative effectiveness research should be to provide patients, physicians, and healthcare providers with the best available information to help assess the effectiveness of various treatments and therapeutics. This cannot be done if the studies are influenced by companies whose products are being evaluated or conducted by researchers with financial conflicts-of-interest. For this reason, we strongly urge you to include the House language on comparative effectiveness research in the final health care reform bill.
Breast Cancer Action
Center for Medical Consumers
Community Access National Network
Government Accountability Project
National Consumers League
National Physicians Alliance
National Research Center for Women & Families/Cancer Prevention and Treatment Fund
National Women’s Health Network
Reproductive Health Technologies Project
Steven E. Nissen, MD
THE TMJ Association
Union of Concerned Scientists
The Patient and Consumer Coalition includes nonprofit organizations that represent patients, consumers, health care providers, scientists, researchers, and other stakeholders who believe that our nation’s health care will improve if based on the best possible objective evidence to support sound medical decision-making.
For additional information, contact Paul Brown at the National Research Center for Women & Families, (202) 223-4000 or firstname.lastname@example.org
Read the original letter here.