Comparative Effectiveness Research is Lacking, Says Study

Janice Simmons, for HealthLeaders Media , March 11, 2010

An analysis by researchers of comparative effectiveness (CE) studies found that only a few compared medication use with nonpharmacologic interventions, and that only a few examined safety or cost effectiveness, according to a study this week in the Journal of the American Medical Association.

Michael Hochman, MD, of the University of Southern California, Los Angeles, and Danny McCormick, MD, MPH, of Harvard Medical School, Boston, looked at the characteristics and prevalence of CE research on medications published between June 2008 and September 2009 in six general medicine and internal medicine journals. They identified 328 studies evaluating medications—104 of which were CE studies.

Of the 104 CE studies, 43% compared two or more medications with each other, 11% compared medications with non pharmacologic interventions, 31% compared different pharmacologic strategies, and 15% compared different medication doses, durations or frequencies of treatment, or different medication formulations. Nineteen percent of the CE studies focused on safety and 2% included cost effectiveness analyses.

The CE studies were less likely than non CE studies to have been exclusively commercially funded: 13% vs. 45%. In total, noncommercial entities jointly or exclusively funded 87% of the CE studies. Government entities at least partially funded 63% of the 104 CE studies.

Comparative effectiveness research last month received the new name of "patient-centered health research" in the President's proposed fiscal 2011 budget, with a proposed request in that budget for $286 million.

The study "highlighted the gap there is in [this] area of research," says Patrick Conway, MD, who is chief medical officer with the Office of the Assistant Secretary for Planning and Evaluation in the Department of Health and Human Services.

"Of course, we always need to know more—especially within CER [by] comparing different lifestyle interventions, prevention, and delivery system interventions. It's much broader that just medication. We need to think about funding the spectrum of comparative interventions," adds Conway, who also co-authored an accompanying editorial in JAMA.

Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at

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