A study of the healthcare systems of the United Kingdom, Australia, Canada and Germany concludes that if implemented correctly, comparative effectiveness has the potential to improve care and reduce healthcare costs for Americans.
"The results of our study demonstrate that, while the lessons from the other countries' approaches to comparative effectiveness are instructive, a cut-and-paste approach will not work in the United States," said Paul H. Keckley, Ph.D., executive director of the Deloitte Center for Health Solutions.
The study, conducted by the Deloitte Center for Health Solutions, illustrates how comparative effectiveness can be used to identify benefits and limitations that can help the U.S. healthcare system learn from the other systems
"Comparative effectiveness can be seen as an engine for renewed innovation in the design and delivery of evidence-based care. Healthcare information technology (HIT), such as electronic health records, may also play a critical supporting role in its evolution," said Keckley.
"As the life sciences industry braces for healthcare reform, comparative effectiveness has the potential to fundamentally change the industry," said Terry Hisey, vice chairman and U.S. Life Sciences industry leader at Deloitte LLP. "Our report examines how comparative effectiveness programs leverage both medicine and clinical decisions to achieve varying results across different patient populations.
Findings from the report conclude:
- Although annual healthcare investment in the United States is $2 trillion, less than 1 percent is invested in assessing the comparative effectiveness of available interventions.
- The American Recovery and Reconstruction Act (AARA) of 2009 allocated $1.1 billion to comparative effectiveness research. Although this represents a major increase in resources for this research, the cost of building national programmatic capacity and establishing a comparative effectiveness framework, support for trials, syntheses and analytics and the development of dissemination and education strategies will challenge this investment.
- National governments in Britain, Canada, Germany, Australia, France and the Netherlands have responded with unique strategies to deal with evidence development in clinical and comparative effectiveness.
- Britain and Australia have designed programs that are directly linked to decisions that determine national health benefits. Germany and Canada use the outcomes of their programs in an advisory capacity for national health benefit decisions.
- Building capacity to expand study, monitoring and clinical application of the relative effectiveness of healthcare interventions is a major challenge in reforming the U.S. healthcare system.
"For comparative effectiveness to work in the United States, it will require cooperation between all stakeholders, from life sciences companies to payers, providers, policymakers and consumers, to achieve maximum benefits," said Hisey.
Deloitte examined three clinical examples of comparative effectiveness studies across the four countries' national programs: diagnostic screening detection (colon cancer), a medication (the use of statins for treatment of elevated cholesterol) and a surgical procedure (treatment for benign prostatic hyperplasia).