According to a recent study published in the October issue of Health Affairs, comparative effectiveness studies of widely used treatments can change practice patterns, thereby reducing healthcare costs.
In the Health Affairs study, the researchers examined two studies, one published in 2002 and the other in 2008, in the New England Journal of Medicine. The studies were of clinical trials showing that arthroscopic debridement and lavage of the knee, a widely used surgical treatment to remove damaged tissue and debris in the knee, did not benefit patients with osteoarthritis of the knee any more than less-expensive or less-invasive options.
To find out if the two comparative effectiveness studies changed practice patterns, the study's authors examined the rates of the procedure in outpatient surgery centers from 1998 to 2010 using ambulatory surgery data in Florida. They found that arthroscopic debridement and lavage procedures per 100,000 adults declined 47 percent, translating into a national savings of $82 to $138 million annually.
"We wanted to find out if these comparative studies affected whether physicians stopped performing these ineffective procedures, despite the fact that the procedure is widely used. I found that it did," said David Howard, co-author of the Health Affairs study and an associate professor in the health policy and management department at Emory University in Atlanta. "This leads to a cost savings because while it's not one of the most expensive procedures out there, it reduces costs when it's not done, and it doesn't adversely affect patient outcomes."
Many physicians nationwide chose to stop using arthroscopic debridement and lavage of the knee in part due to the New England Journal of Medicine studies, noted Howard, and instead performed less expensive and invasive procedures on their patients.
Howard added that while not every physician will listen to a comparative effectiveness study on whether or not a procedure is useful or not, it's still a good idea to continue to fund such studies on widely-used treatments that have not been tested. "You might find that these treatments do work or you might find that they don't," he said. "You might find that a more expensive option doesn't work much better than something less expensive, and in that case you have an opportunity to reduce costs."