Looking back … and looking forward

Each year seems busier and more tumultuous than the last, but it would be hard to top 2009. Budgets and payrolls tightened as every part of the health care sector faced major business challenges, and the uncertainty of the health care reform debate in Washington grew larger as the year progressed. So as the year closes, we at the National Pharmaceutical Council think it’s worthwhile to look back at what happened this year, and just as importantly, what might happen in 2010.

The year began with debate and confusion about comparative effectiveness research (CER) and evidence-based medicine (EBM), priority topics for NPC. To help policymakers and health care stakeholders sort out the confusion, we doubled our in-house research capacity by hiring Les Paul, MD, MS, as Vice President of Clinical and Scientific Affairs, and Jennifer Graff, PharmD, as Research Director, Methods, Evidence and Coverage.

The emergence of CER/EBM as major flashpoints for the health care reform debate made their contributions all the more important. It has become clear that defining what makes high quality comparative effectiveness research will be critical not just to legislators now, but to payers both private and public over the next several years.

NPC assisted with that by developing its own "Key Considerations for CER," as well as by hosting a CER forum in June and a briefing for congressional staffers in July. In December, the report Demystifying Comparative Effectiveness Research provided guidance on how to evaluate CER, including some easy-to-use “checklists” to help make sure such studies can be used to better inform health care decision-making and to improve the dialogue between health care providers and patients.

Another important discussion this year focused on how the health care sector can work with the employer community, which, after all, pays for much of the health care in the U.S. Some of that discussion centered on how to help employee and employers get the best value for their health care dollars. NPC informed that discussion in August with the release of the Value-Based Insurance Design Landscape Digest. This important report has led to further study and increased conversations with the employer community about how to use benefit design to encourage adherence to recommended treatments and improve health outcomes.

It’s clear to many employers – and ought to be clear to even more – that health care and the bottom line are directly related. An NPC-sponsored study published in the April Journal of Occupational and Environmental Medicine, which won the DMAA: The Care Continuum Alliance’s 2009 Population Health Improvement Leadership Award for Outstanding Journal Article, showed that poor health among workers is far costlier to U.S. employers than they realize, impacting their profitability and undercutting the nation’s overall productivity. NPC will continue to work on this topic in the New Year as we undertake additional research on the impact of health on businesses.

As we finish this decade and head into 2010, the difficult squeeze on health care providers, payers and policymakers – and patients – seems likely to continue. That means the focus on effective patient care across the health care spectrum will have to be prioritized. As 2010 comes into view, NPC will remain a venue for serious, research-driven discussions that help policymakers, payers and providers deliver effective care.