Comparative Effectiveness

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In the LA Times today, researchers Michael Hochman and Danny McCormick explain the sorry current state of comparative medical research. On a broad range of topics, we simply don’t know which treatments work best:

In this week’s issue of the Journal of the American Medical Assn., we report the results of a study that may help explain why we don’t. In the study, we analyzed 328 medication studies recently published in six top medical journals and found that just 32% were aimed at determining which available treatment is best. The rest were either aimed at bringing a new therapy to market or simply compared a medication with a placebo. Whether the therapy was better or worse than other treatments was simply not addressed.

….Why [] did only a third of medication studies focus on helping doctors use existing therapies more effectively? The answer lies in the fact that pharmaceutical companies fund nearly half of all medication research, including the lion’s share of large clinical trials. For obvious reasons, commercially funded research is primarily geared toward the development of new and marketable medications and technologies. Once these products have won approval for clinical use, companies no longer have incentives to study exactly how and when they should be used.

At the risk of joining the forces of socialism and death panelism, this is why the federal government should be funding a lot more of these studies. The free market won’t do it — in fact, in many cases the free market actively resists studies like this — and our lives are shorter and poorer for it. Our lives are, quite possibly, also more expensive for it, since the most effective treatments aren’t always the most expensive ones.

And you know what would help fund more of these studies? The Democratic healthcare bill! Wouldn’t it be great if that passed?

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