Traditional drug and device research aims to show whether a drug or device has a some positive effect, and doesn’t kill or hurt any more people than not using it. Comparative effectiveness research (CER), in contrast, compares the drug or device with all alternatives, to find out whether is works better than the alternatives, kills or maims fewer people than the alternatives, and/or does its wonderful stuff cheaper than the alternatives. Makes sense. It’s what we need for sophisticated medical shopping.
According to the Pacific Research Institute recently, because of “Comparative Effectiveness Research” (CER) “under conservative assumptions, R&D investment in new and improved pharmaceuticals and devices and equipment would be reduced by about $10 billion per year over the period 2014 through 2025, or about 10-12 percent. This reduction in the advance of medical technology would impose an expected loss of about 5 million life-years annually, with a conservative economic value of $500 billion, an amount substantially greater than the entire U.S. market for pharmaceuticals and devices and equipment.” [Study available here.]
I haven’t read the study. I don’t need to, since it is so obviously true, if we just make certain assumptions, such as:
- Every dime spent on R&D for drugs and devices is wisely spent, on advances that will save and improve lives.
- Every dime spent on finding out whether those drugs and devices actually work as advertised, and don’t actually kill people, and do it better or cheaper than other drugs and devices, is a dime wasted. CER just slows down legitimate, helpful research.
- Experience does not show us any examples of wasteful or unnecessary drugs or devices. Those multiple peer-reviewed research papers showing that we waste hundreds of billions of dollars every year on useless complex back surgeries, the 22% of implanted defibrillators that are unnecessary, tens of millions of unnecessary scans, coronary stents put in people with stable heart disease and no heart pain, the heartburn surgeries that work no better than over-the-counter drugs—those studies are all false, wrong, some kind of mumbo-jumbo that we can safely ignore.
If we just make those few simple assumptions, the study has a valid point. If we don’t accept those assumptions, we have to wonder about the mental state, motivations, and personal finances of someone who would cook up such an obvious bit of flim-flam.
By Joe Flower