Comparative effectiveness research aimed at determining the efficacy of medical treatments could deprive the country of $4 trillion in economic activity and 81 million years of life, contends a new report from the Center for Medicine in the Public Interest.
"Our analysis shows that CER could significantly stifle innovation," said John A. Vernon, a professor at the University of North Carolina at Chapel Hill and co-author of the study. "As a result, Americans will live shorter lives in poorer health. Simply put, CER will cause us to produce less health."
[See also: Comparative effectiveness study evaluates savings opportunities for U.S. healthcare; Hackbarth discusses comparative effectiveness research]
CER is one of the cornerstones of the Patient Protection and Affordable Care Act, with proponents saying it will help determine which services and treatments produce actual health benefits. Their contention is that some of the increases in healthcare spending are the result of overuse of new diagnostics, medical devices and pharmaceuticals.
Supporters say determining which treatments are cost-effective and have real health benefits – versus those that add to healthcare expense without real health benefits – will help the Centers for Medicare and Medicaid Services and other payers more effectively target healthcare dollars.
In the process, proponents have said CER can be used so "that Medicare spending – and perhaps all health spending in the country – could be cut by about 30 percent if the more conservative practice styles used in the lowest spending one-fifth of the country could be adopted nationwide," according to a 2007 report on CER by the Congressional Budget Office.
But CMPI suggests otherwise. Officials say its study demonstrates that CER will reduce the level of investment in pharmaceutical research and increase the cost of developing new treatments. As a result, it says, pharmaceutical research and development spending would decline by $32 billion over 10 years.
"Comparative effectiveness research would put the brakes on medical innovation and prevent many groundbreaking drugs from ever being invented," said Robert Goldberg, vice president of CMPI and co-author of the study. "Investments in medical research provide among the most productive uses of capital in the economy. Americans will suffer economically and physically if the government forces CER on the U.S. healthcare system."
CMPI officials suggest that because CER will reduce research activities and add costs and longer development times to those innovations that do reach the market, it will have a negative effect on life expectancy – equal to 34 million life years over the course of 10 years and 81 million life years in perpetuity.
By applying a 'value' of $50,000 per year of human life, the study arrives at the total cost of CER as $1.7 trillion over 10 years and $4 trillion in perpetuity.
"Proponents of CER have responded to general criticism of using findings to make coverage decisions by claiming that absent such research, the United States will be unable to control rising health costs because of the unfettered adoption of medical innovations," the study noted. "Our research shows that there is hard evidence behind our concern about using CER to illuminate difficult tradeoffs. On the contrary, our analysis suggests that because CER will lead to a loss of innovation, Americans will live shorter lives, and in poorer health than would otherwise be the case. Simply put, we will produce less health."