The growing availability of different types of health information can make it challenging for decision-makers to appropriately evaluate this information and make informed decisions about treatment options. With increased private and public funding for comparative effectiveness research, there will be a greater amount of data that is drawn not only from randomized controlled trials (RCTs), but also from a wide range of other study designs (observational studies, simulations, or comparisons between studies) and sources (registries, administrative claims, or electronic medical records).
There is very little guidance on how to evaluate and use these studies, which leaves that information open to wide interpretation and disparate use by decision-makers. With an expected increase in the availability of comparative effectiveness research, tools and resources are needed to help formulary decision-makers navigate through this research and use it effectively to inform coverage decisions.
To provide greater uniformity and transparency in the evaluation and use of evidence for coverage and health care decision-making, the Academy of Managed Care Pharmacy, the International Society for Pharmacoeconomics and Outcomes Research, the National Pharmaceutical Council, and their respective members have joined forces as the CER Collaborative Initiative to develop tools, resources, and training materials to aid formulary decision-makers, the researchers who are developing information for use by decision-makers, the biopharmaceutical industry, and other health care stakeholders.
Tools, resources and training materials include:
Online Tools and Training. To navigate these tools and enable decision-makers to assess the evidence in a consistent manner, online tools to assess individual studies and synthesize the evidence from multiple studies, training materials, and additional resources are available. Watch the webinar below to learn more about the tools the CER Collaborative has developed.
CER Collaborative CER Continuing Education Certificate Program. The CER Collaborative, in conjunction with the University of Maryland School of Pharmacy, has developed the CER Collaborative Continuing Education Certificate, a 19-hour certificate program to guide pharmacists and other clinical decision-makers by advancing their expertise in assessing evidence and making use of the online CER Collaborative tool and resources. The program provides continuing education credits.
Assessing the Evidence: An Individual Study. A series of interactive questionnaires were developed to help decision-makers assess whether the study is relevant to their setting or decision and credible enough to include in the body of evidence. Users can store their information, share their critical appraisal with colleagues, and access their analyses over time. The Collaborative has initially focused on four research study types:
- prospective observational studies
- retrospective observational studies (administrative claims or electronic records)
- modeling studies; and
- network meta-analysis or indirect treatment comparison studies (when two or more treatments have not been compared, but each has a common comparator and are compared indirectly)
Synthesizing A Body of Evidence: Multiple Studies. Formulary decisions require rigorous evaluation of the body of evidence. Because there are different study designs (e.g., randomized controlled trials, observational studies, and simulations) each with strengths and limitations, it can make it difficult to combine and analyze the evidence in a systematic way.
A framework was adapted to assess the comparative benefits and risks of therapies and the corresponding certainty of these benefits and risks. The framework, user guide and online tool enable users to synthesize the evidence from multiple studies in a consistent and transparent manner to guide coverage and formulary placement. Users can store their evaluation of the body of evidence, share their synthesis with colleagues, and access their evaluations over time as new information becomes available or is treatments are re-evaluated.