The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union AHRQ 2007 Annual Conference September 27, 2007

Case study: How comparative-effectiveness research can benefit consumers and taxpayers. What made our project possible: Drug Effectiveness Review Project (OHSU; basis for Medicaid drug decisions by participating states) Powerful model that can be expanded.

About Consumer Reports Trusted source of objective information since 1936 Accepts no advertising and is independent of all commercial interests including drug companies Independent Non-profit

Mission: Provide unbiased in-depth information on prescription drugs for consumers and doctors Increase access and affordability to needed medicines Relieve financial burden caused by high drug prices

Goals for Consumers Provide them with objective information on effectiveness of prescription drugs Help them open a discussion about drug costs with their doctor Help them afford the medicines they need (copayments, donut, uninsured)

Identifying CR Best Buy Drugs Start with credible source of unbiased, rigorous analysis of clinical evidence about drug effectiveness (DERP) Intense medical input through consultants, internal CU review, and medical peer review Selections based on effectiveness, safety record, and price

Present Information in Easy to Use Format (back side of 2 page report)

The Statins Introduction of generics: changing marketplace Huge stakes: $8 billion for Medicare beneficiaries alone Major health consequences of greater affordability

Possible Annual Savings: 5 Categories Statins $1,300 (cholesterol) Proton Pump Inhibitors: $2,000 (acid reflux and ulcers) NSAIDs $2,200 (arthritis and pain) Anti-depressants$1,200 Beta Blockers$1,900 (high blood pressure)

Average Cost PlanHighest Cost Plan

Outreach and Intermediaries Six states (GA, CA, AZ, MN, MD and PA) Pharmacists, Doctors, Libraries, Senior groups, Employer and Employee Organizations Recruit your doctor campaign Agreement with Medco Project with WEA Trust Outreach to doctors through Tarascon

Early lessons from our outreach efforts: Consumers have different needs Need to work through trusted intermediaries Importance of trustworthy sources Learn more about how to communicate with consumers Remember those without Internet access

WEA Insurance Trust 2 nd largest health insurer in Wisconsin (non profit, public education employees and families) Conducted informational campaign directed to beneficiaries using Proton Pump Inhibitors (PPIs): -- sustained increase in market share of Prilosec OTC -- Individual out-of-pocket costs reduced $36,000 --$455,000 in savings to the Trust

Best Buy Drug Reports on Pocket Pharmacopoeia – PDA Reference

Change the information model from:

To: unbiased, evidence-based information