NPC Examines CER as Health Reform Takes Hold

What's on the National Pharmaceutical Council's (NPC) radar for 2013? NPC President Dan Leonard takes a closer look at comparative effectiveness research (CER), state health exchanges and benefits, and value-based health care environments such as accountable care organizations in a commentary published today in Chain Drug Review. Leonard writes, "Given the millions of dollars being spent on CER each year, CER that is conducted in a rigorous and high-quality manner has the potential to greatly improve health outcomes for patients. And that’s a powerful thought. Patients need better information to guide them in their decisions, especially in areas that science has not fully addressed, such as patients with chronic conditions and those who face multiple health challenges." But, he cautions that CER success depends on how well patients are engaged in the research process, how the research is conducted and disseminated, and how the research can be communicated.

Leonard also discusses the challenges facing state policymakers who are developing state health insurance exchanges. "Under one design option the state health insurance exchanges would cover only one drug to treat a given condition. By pushing a standardized treatment for every patient, this model could lead to poor outcomes for the patients who see limited or no benefit from that particular drug. States are wrestling with this issue as they decide whether to cover a single drug, several drugs or the full range of medications for a health condition.

"The evidence has shown us that 'one size fits all' approaches, like those being considered by some state insurance exchanges, can mean poor outcomes for key subgroups of patients. When individual patients respond poorly due to heterogeneity, the health care system in turn must devote more time and money to making them well," he writes.

Finally, Leonard says, "As providers evaluate optimal care for their patient populations" in value-based health programs like accountable care organizations, "prescription medications should be thoughtfully integrated into the process. That’s because when medications are appropriately used they can contribute significantly to improving patient outcomes and reducing overall costs."

Read the full text online on Chain Drug Review's website.