Selling Comparative Effectiveness: Practice May Need Positive Branding

Full article reprinted from "The Gray Sheet" - December 21, 2009

With the national infrastructure for comparative effectiveness research set to expand, the government should be thinking about how to get out a positive message about the oft-maligned practice, policy experts say. Read more...

Full article  from "The Gray Sheet" - December 21, 2009

With the national infrastructure for comparative effectiveness research set to expand, the government should be thinking about how to get out a positive message about the oft-maligned practice, policy experts say.

Both the Senate and House health care reform bills contain robust CER policies that are likely to survive even if other parts of the broad-based bills falter.

"Clearly, AHRQ knows, and NIH knows, they are going to have to sell CER," said Steve Findlay, a policy analyst with Consumers Union, at a congressional staff briefing on Capitol Hill Dec. 15. "Now their main constituency is ... the policy community and researchers."

The Agency for Healthcare Research and Quality already has $10 million from the economic stimulus package CER funding to create a group called the "Citizens' Forum" to expand patient and doctor awareness of and involvement in AHRQ's CER initiative, Findlay noted.

On Dec. 3, AHRQ issued a ¹ request for solicitations from small businesses to develop methods to launch the Citizens' Forum, and to get the public to participate in using comparative effective evidence for making health care policy.

Mammogram Tempest Puts CER In Bad Light

Unfortunately, the benefits of comparative effectiveness research sometimes can be obscured when consumers, patients and physicians get mixed messages about how to apply the results of the research. This became apparent during the recent controversy over mammography guidelines updated by the U.S. Preventive Services Task Force, said Steven Pearson, president of the Institute for Clinical and Economic Review, at the briefing.

USPSTF, after reviewing comparative studies, recommended against routine screening for breast cancer for women between age 40 and 49. This alarmed many who believe that earlier screening saves lives (² 'The Gray Sheet' Nov. 23, 2009).

The task force members ultimately acknowledged poor communication for their findings, which, they said, were not intended to restrict women under 50 from getting a mammogram. But the recommendations ruffled so many feathers that the Senate amended its health reform bill earlier this month to provide assurances that the recommendations would not restrict coverage for mammograms (³ 'The Gray Sheet' Dec. 7, 2009).

"If new information contradicts your experience, that's very, very difficult," said Carolyn Clancy, who directs AHRQ, at a meeting earlier this month. As a lesson from the mammography situation, she said, "I think we need to understand much more about how people process information."

Pearson said it will take "total innovation" to simplify and sell the CER message, but in the meantime, "We are going to muddle through; we are going to put our foot in it, just like we did with mammography."

He suggested that professional advertisers might need to be contracted to sell a positive comparative effectiveness research message. He also predicted a strong role for IT experts in creating social networking sites that disseminate personalized comparative effectiveness information about alternative treatments.

Findlay: "Play Offense" To Promote CER Adoption

Controversies abound in Congress and in the general public about the potential for comparative effectiveness studies to restrict the practice of medicine and physicians' ability to choose treatments. In response, CER supporters need to start "playing offense" to get positive messages across, Findlay said.

"It's really about putting better information into doctors' hands," he said. "Success will hinge on efforts to package and present CER to the public."

Good CER talking points, Findlay said, include: that the research enhances personalized medicine; that it strengthens doctor-patient relationships; that it empowers consumers and physicians; and that it prevents unnecessary treatments.

- Sue Darcey

Limited-time offer: Single-incision laparoscopy or natural orifice surgery: Which will win the day, or is there room for both? Are You Ready For The New Scarless Surgery Revolution? Download you FREE report now

To find out about more about more about Elsevier Business Intelligence's medical device publications and databases, multi-user access and/or advertising with Medical Devices Today, please contact Sean Smith at 240-221-4535 or se.smith@elsevier.com.