Transcript Health Summit - Bipartisan Policy Center

John Santa MD MPH, Health
Advisor/Consultant
April 2008
The Problem
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Half of what doctors do is evidence-based.
Unnecessary care harms patients and
wastes $$$.
System poorly organized for comparing
treatments and providers.
Consumers are lost in the maze.
Conflict-of-interest is rife in health care.
Doctors lack information to make the best
possible clinical decisions.
Consumers lack information to choose
among treatment and provider options.
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Barriers to Change
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Comparative effectiveness research is very
expensive.
Aggregation of data and findings is hard.
Data is inconsistent across states, health plans,
benefit designs.
Some companies resist sharing data.
Doctors are hard to reach and influence.
Consumers are skeptical, worry about access
being blocked.
Some industries fanning consumer fears.
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Consumer Reports
Our mission since 1936 …
an expert, independent,
nonprofit, nonpartisan
organization, whose mission is
to work for a fair, just, and safe
marketplace for all consumers.
What we do: test, inform and
protect.
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Our Approach
Consumers want trustworthy, easy-tounderstand, actionable information.
 No commercial agendas, advertiser
influences or financial relationships.
 Involve consumers from the outset in
choosing topics for evaluation and
effective translation methods.
 Work with advisors and groups who
are independent and unbiased.
 Consumers love ratings!
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Our Health Ratings to Date
Health Plans
 Nursing Homes
 Health Care Products & Devices
 Nutritional Supplements
 Medical Treatments
 Prescription Drugs
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Identifying CR Best Buy Drugs
• Start with credible source of
unbiased, rigorous analysis of
clinical evidence about drug
effectiveness (DERP)
• Intense medical input through
consultants, internal CU review,
and medical peer review
• Selections based on effectiveness,
safety record, and price
What We Found
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Cholesterol Drugs – For most people, new
generics are just as good.
Alzheimer’s Drugs – Not very effective in
preventing mental decline.
Diabetes Drugs – Newer, expensive
medications are no better and less safe.
Heartburn Drugs – Over-the-Counter drugs
just as good as expensive brands.
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Millions view information on
www.CRBestBuyDrugs.org or other partner Web
sites.
Medco uses CRBBD content. In one initiative,
4.3% of statin users switched to lower-cost
generics. Savings: $8 million.
The Wisconsin Education Association Trust also
used CRBBD materials. Savings: $455,000
from switch to lower-cost heartburn drugs.
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Policy Issues
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Need reliable source of ongoing funding for
comparative effectiveness research.
Test ways to incorporate comparative effectiveness
into benefit design and reimbursement.
Target funding at consumer friendly “translations”
and dissemination.
Payment reform must reward providers for using
evidence-based practices.
Explore tiered co-pays to reward consumers for
choosing evidence-based care.
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Policy Issues
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Eliminate conflict-of-interest at critical decision
points (training, research, regulation, purchasing,
point of care).
Create more conflict-free independent “islands”
of health research and delivery, like DERP and
AHRQ’s Evidence-Based Practice Centers.
Educate consumers on what “transparency”
really means to them.
Deploy HIT & e-Rx to dramatically improve
patient safety.
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