1. How Can Comparative Effectiveness Research Benefit Consumers?
Second National Congress on the
Un and Under Insured
September 23, 2008
Gail Shearer
Consumers Union

2. “Comparative Effectiveness”
Everyone is talking about it!

3. “Comparative Effectiveness”
Confusion about what it is!

4. “Comparative Effectiveness”
Stakes are high:
If history is a guide…

5. Key Issues Organizational structure
How to engage stakeholders AND avoid conflict of interest?
Include cost-effectiveness?
How succeed when so many early efforts failed?
How fund?

8. 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

9. Possible Annual Savings: 5 Categories
Statins $1,300
(cholesterol)
Proton Pump Inhibitors: $1,740
(acid reflux and ulcers)
NSAIDs $2,200
(arthritis and pain)
Anti-depressants $1,200
Beta Blockers $1,900
(high blood pressure)

11. Average Cost Plan
Highest Cost Plan

13. Quality Improvement Organization funded by CMS to provide technical assistance to providers
CR Best Buy Drugs materials used to educate both staff & consumers in 4 physician practices
Goal: Increase use of generic statins among diabetic patients
Delaware law encourages pharmacists to substitute generics: Prescription for brand w/generic alternative a vital step

14. Change in Prescribing Patterns
Baseline
Follow Up

17. Changing from this model of provision of information:

18. To unbiased, evidence-based information: