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The Participant-Reported Implementation Update and Score (PRIUS): A Novel Method for Capturing Implementation-Related Data Over Time
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The pragmatist's guide to comparative effectiveness research.

Amitabh Chandra1, Anupam B Jena, Jonathan S Skinner

  • 1Harvard Kennedy School of Government, Harvard University, and the National Bureau of Economic Research, Cambridge, Massachusetts, USA. amitabh_chandra@harvard.edu

The Journal of Economic Perspectives : a Journal of the American Economic Association
|May 21, 2011
PubMed
Summary
This summary is machine-generated.

Comparative effectiveness research (CER) compares healthcare treatments without cost analysis, offering a politically viable alternative to cost-effectiveness analysis. CER provides crucial efficacy data, with costs to be added later.

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Area of Science:

  • Health Services Research
  • Health Economics
  • Medical Decision Making

Background:

  • The Patient Protection and Affordable Care Act of 2010 prohibited cost-effectiveness analysis in US government health programs.
  • This prohibition stemmed from political debates, including accusations of "death panels."
  • Comparative effectiveness research (CER) emerged as an alternative to assess healthcare interventions.

Purpose of the Study:

  • To evaluate the promise and utility of comparative effectiveness research (CER) as a strategy in healthcare.
  • To address the limitations of cost-effectiveness analysis in the current political climate.
  • To highlight the importance of efficacy data in healthcare decision-making.

Main Methods:

  • CER compares the efficacy of diagnostic tests, treatments, or healthcare delivery methods.
  • This approach explicitly excludes cost considerations during the initial assessment.
  • The study argues for CER's value despite the omission of costs.

Main Results:

  • CER bypasses political resistance to incorporating costs in healthcare analysis.
  • There is a significant lack of comparative effectiveness data for many treatments and drugs.
  • CER can serve as a crucial initial step by providing essential treatment effect estimates.

Conclusions:

  • Comparative effectiveness research offers a pragmatic approach to evaluating healthcare interventions.
  • By focusing on efficacy, CER provides valuable data that can inform clinical practice and policy.
  • Cost data can be integrated into CER findings at a later stage, making it a flexible and promising research strategy.