Comparative Effectiveness Research May Not Lead to Lower Health Costs or Improve Health

One health reform policy option that already has been implemented through the federal stimulus package is increasing research that will determine what are the best treatments for various illnesses. Commonly referred to as comparative effectiveness research, the studies can examine which treatment will have the best result and the costs associated with different options.

A new analysis from the RAND Corporation finds that while there are benefits to having better information for doctors and patients about what works best in treating different health problems, it is uncertain that the research will lead to reductions in spending and waste or improvements in patient health.

Under some circumstances comparative effectiveness research might reduce spending for certain diseases, but there is no clear evidence that a large new undertaking in this area would result in overall savings to the U.S. health care system, according to the analysis done as a part of the RAND COMPARE initiative.

The new analysis is presented on the RAND COMPARE Web site's Policy Options Dashboard. COMPARE is an ongoing effort by the nonprofit RAND Corporation to provide objective information about health care reform.

"While increasing research aimed at determining the most effective treatments for a wide array of diseases should have benefits, there is not enough evidence at this point to predict exactly what the result might be for the cost of the nation's health care system," said Elizabeth McGlynn, co-director of COMPARE at the RAND Corporation, a nonprofit research organization.

The RAND COMPARE analysis synthesizes the background and history of comparative effectiveness research, describing how it is used both in the United States and in other nations where some government agencies use it to determine whether to pay for certain types of treatment.

Comparative effectiveness research could help reduce health care spending by producing clear guidelines that point to superior and potentially less costly choices for medical treatment. By reducing the use of less productive treatment options, the research could contribute to efforts to drive down medical spending.

Researchers say that one challenge for any such effort is to present the findings in such a way that both health providers and patients are motivated to change their behavior. Past efforts have shown that incentives or other mechanisms may be needed to change behavior. Because the stimulus bill specifically prohibits using the results of federally funded comparative effectiveness research for to guide payment policy or benefit design, developing strong incentives that will drive down spending is considerably less likely.

RAND researchers concluded that at least in the near term, any reduction in spending created from comparative effectiveness research would be offset by the up-front costs associated with generating, coordinating and disseminating the research findings.

The federal stimulus legislation approved earlier this year included $1.1 billion for increased comparative effectiveness research, adding to the funding for such efforts already provided by several federal agencies including the National Institutes of Health and the Agency for Healthcare Research and Quality.

RAND Health, a division of the RAND Corporation, is the nation’s largest independent health policy research program, with a broad research portfolio that focuses on quality, costs and health services delivery, among other topics. RAND Health is the developer of COMPARE (Comprehensive Assessment of Reform Efforts), a one-of-a-kind online resource that provides objective analysis about national health care reform proposals. Visit www.randcompare.org to learn more.