Possible Outcomes of Comparative Effectiveness Research

With substantial support across the political spectrum, the Obama administration has included in the American Recovery and Reinvestment Act more than $1 billion to support comparative effectiveness research. At the same time, the president has demanded reforms in the US health care system to make health care more affordable for all US citizens. This Commentary focuses on the interaction of these 2 initiatives: what will be the cost effect of spending $1 billion on comparative effectiveness research? First, it is important to understand what comparative effectiveness research will include. Discussions to date suggest that most of the funds will be spent comparing one clinical procedure, device, or drug with another. The funds are less likely to be spent testing the comparative effectiveness of one way of paying for care vs another, of organizing care using a chronic disease model vs another organizational principle, or of implementing aggressive disease management programs.