President Obama and House Democrats "embrace the creation of a ... 'comparative effectiveness' entity that will do research on drugs and medical devices" -- similar to the National Institute for Health and Clinical Excellence in Great Britain, which evaluates new medical products' cost effectiveness before citizens gain access to them, Scott Gottlieb, a resident fellow at the American Enterprise Institute, writes in a Wall Street Journal opinion piece.
While Obama and House Democrats "claim that they don't want this to morph into a British-style agency that restricts access to medical products based on narrow cost criteria, ... provisions tucked into the fiscal stimulus bill betray their real intentions," according to Gottlieb.
The economic stimulus package includes $1.1 billion "for studies to compare different drugs and devices to 'save money and lives,'" and language in a report about the House bill states that "more expensive" medical products "will no longer be prescribed," according to Gottlieb.
"The House bill also suggests that the new research should be used to create 'guidelines' to direct doctors' treatment of difficult, high-cost medical problems," Gottlieb writes. In addition, the bill would give HHS Secretary-designate and former Senate Majority Leader Tom Daschle (D-S.D.) "wide discretion to set priorities, and he's long advocated a U.S. approach modeled on" NICE, according to Gottlieb.
He continues, "The biggest flaws in the House Democratic plan aren't just political, they're scientific," adding, "Key comparative medical questions usually hinge on when doctors should escalate care to include more invasive measures -- not on bare comparisons between otherwise similar technologies, which is the focus of the House proposal." He concludes that "the House plan isn't really about filling evidence gaps -- it's about controlling costs. 'Science' is merely a veneer" (Gottlieb, Wall Street Journal, 1/20).
Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign up for email delivery at kaisernetwork.org/email . The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2007 Advisory Board Company and Kaiser Family Foundation. All rights reserved.