Transcript Bringing Evidence-Based Medicine to Consumers

Bringing Evidence-Based Medicine to Consumers
Alliance for Health Reform
January 12, 2005
Gail Shearer
Director, Health Policy Analysis
Washington Office
Consumers Union
“Consumer Driven” Health Care?
• Is it defined contribution health care in reality?
• Adverse segmentation of the health insurance
marketplace
• Evidence-based medicine should be foundation
for universal coverage, comprehensive drug
benefits, and improvements in the marketplace
as it saves money and rationalizes delivery of
care
Section 1013: Medicare Modernization Act
• Bipartisan effort
• Appeals to those who want to provide financial
relief
• Appeals to those who want to curb federal
spending and deficit
• AHRQ priorities: constructive first step
• Section 1013 calls for findings that are “easily
understood” by the public and available both
online and in print
MISSION:
• Information on prescription drugs for
consumers and doctors
• Increase access to and affordability of
needed medicines
• Relieve financial burden caused by high
drug prices – consumers and businesses
METHODS: (1) Drug Effectiveness Review Project
• Pioneering work under leadership of former
Oregon Governor John Kitzhaber
• Partnership (DERP) now includes 12 states and
two non-profit organizations
• Systematic reviews by AHRQ’s Evidence-Based
Practice Centers
• Process: transparent, unbiased, rigorous, highly
regarded
METHODS: (2) Medical Input and Prices
• Input from medical consultant
• Data on average national retail price paid by
cash-paying consumer
• CU team reviews effectiveness and cost
• Input from CU’s medical advisor, health editorial
team, statistician, 2-3 outside medical peer
reviewers for each category
METHODS: (3) Identifying CR Best Buy Drugs
CU team reviews the effectiveness and cost
data, and selects one or more drugs that:
• Are in the top tier of effectiveness
• Have a safety record as good as others in the
category
• Have an average price substantially lower than
the most costly drug in the category
CR BEST BUY DRUGS: Cholesterol–Lowering
Drugs/Statins
For moderate cholesterol reduction:
• Generic lovastatin
Substantial cholesterol reduction:
• Atorvastatin (Lipitor)
POSSIBLE ANNUAL SAVINGS: 3 Categories
• Statins
(cholesterol)
$1,300
• Proton Pump Inhibitors:
(acid reflux and ulcers)
$1,740
• NSAIDs
(arthritis and pain)
$2,200
Just the beginning …
• Continue to draw on DERP reports
• One per month
• Next up: anti-depressants (SSRIs), high
blood pressure and heart disease (ACE
Inhibitors and Beta Blockers)