House panel curbs comparative-effectiveness research

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The healthcare reform bill approved last week by the House Energy and Commerce Committee contained an amendment prohibiting the federal government from using comparative-effectiveness research to “deny or ration care.”

Rep. Michael Rogers, R-Mich., who sponsored the amendment , criticized the pre-amendment language in the bill for containing “no restriction on how the federal government can use this research.

“This is a dangerous open-door policy that will almost certainly lead to comparative-effectiveness research being used to make coverage decisions,” Rogers said.

Comparative-effectiveness research is designed to help identify treatment options that are most effective for a given condition, and the Obama Administration has latched on to it as a strategy in its efforts to reform the U.S. healthcare system.

Rogers, in presenting his amendment, said the federal government cannot be allowed “to use a calculator or a bureaucratic standard to get between patients and doctors.

"Comparative-effectiveness research is about general average assumptions,” Rogers said. “It can’t determine anything about individual patients with a unique condition looking for a unique treatment.”

Some Democrats on the committee objected to the amendment, with several arguing that the term “deny” was too strong. “To deny care when we find out a procedure is harmful is something we would want the federal government to do,” argued Rep. Henry Waxman, D-Calif., chairman of the committee. Despite his opposition, the amendment passed on a voice vote.

The Senate also is considering comparative-effectiveness research in its healthcare reform efforts. Senate Finance Committee Chairman Max Baucus, D-Mont., and Senate Budget Committee Chairman Kent Conrad, D-N.D., introduced legislation that would establish a private, nonprofit corporation that will research and compare clinical outcomes of alternative therapies and healthcare strategies.

The language in the Baucus-Conrad bill requires the Centers for Medicare and Medicaid Services (CMS) to meet several requirements before allowing the use of any research, including comparative-effectiveness research, to be used to make coverage decisions.