It was in the first months of the Obama administration that the 44th President of the United States endorsed an economic stimulus package to aid in the financial crisis plaguing America. Ultimately, Congress passed and President Obama signed the American Recovery and Reinvestment Act, and included in the multi-billion dollar program was $1.1 million dedicated to the health care industry in order to analyze treatments for particular health problems. The goal was to find ways to cut costs in the future by eliminating ineffective and overpriced treatments.
The Institute of Medicine (IOM) was directed to perform an analysis of medical conditions that could fit into the category of treatments to be streamlined, and in July of 2009, a list was released in a report entitled “Initial National Priorities for Comparative Effectiveness Research.” In it was a detailed list of 100 issues, taken from a batch of 1,268 treatments in total, for use in the project, and the report was delivered to Congress to further the process of deciding on the specific allocation of the funds for the comparative effectiveness research (CER), which is defined by the report as “the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition or to improve the delivery of care.”
Regarding the list of priorities, the report read, in part: “Clinical research provides health care providers with information on the natural history of disease, clinical presentations of disease, and diagnostic and treatment options. All too often, the information necessary to inform these medical decisions is incomplete or unavailable, resulting in more than half of the treatments delivered today without clear evidence of effectiveness. This uncertainty contributes to great variability in managing clinical problems, with costs and outcomes differing markedly across the country.”
Broken down into four quartiles, the first group is the highest priority as determined by the IOM, though all 100 conditions are included to show their viability for the CER program. The topics are intended to be a starting point for more research and improvements, but any that receive stimulus funds must be approved by Congress and adopted by health care providers and organizations before being implemented.
The first twelve topics listed in the first quartile of the report are listed as the HealthNews Dozen, and they range from hearing loss treatments to specific bacterial infections like methicillin-resistant Staphylococcus aureus. But the scope of treatments affected by any decisions for CER are broad, as they can aid in ministering to diseases and conditions that treat millions of people, like rheumatoid arthritis, prostate cancer, and back pain.
Other topics that made the first quartile of the list included behavioral disorders in people with Alzheimer’s disease, meal programs and physical education in schools for children and adolescents, and the prevention of obesity, hypertension, diabetes, and heart disease in people in urban areas and American Indian communities.
As Congress begins to examine all 100 issues and allocate funds for CER, not only will ineffective treatments be less available, but patients and caregivers will have more information about particular conditions and diseases in order to best make their own well-informed decisions while taking into consideration the advice of medical professionals.