Comparative Effectiveness in Healthcare Session at AAAS Meeting

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I attended the annual meeting of the American Association for the Advancement of Science today to hear a session titled “Health Economic Evaluations of Medical Technologies: Is the Cost Worth the Cure?”  The topic of this session was really about comparative effectiveness of medical interventions – particularly pharmaceuticals. The panel was a substantial group of physicians and health services researchers/regulators:

  • Milton C. Weinstein, Harvard School of Public Health
  • Michael F. Drummond, University of York, United Kingdom & NICE (National Institute for Health and Clinical Excellence)
  • Jeffrey Kelman, Chief Medical Officer at CMS
  • Marc Berger, Eli Lilly
  • Tracy A.
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Technology and Health Care Costs

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Peter Orszag, the Director of the Congressional Budget Office (CBO), recently testified before the Senate Budget Committee about increasing health care costs. One of his conclusions was that “the most important factor driving the long-term growth of health care costs has been the emergence, adoption, and widespread diffusion of new medical technologies and services by the U.S. health care system.”

His testimony concludes that by using “comparative effectiveness” research to “generate more information about the relative effectiveness of medical treatments and changing the incentives for providers and consumers,” would create a situation where “savings are possible without a substantial loss of clinical value.”…

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Denial of Off-Label Medicines in Medicare Part D

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I have been helping the Medicare Rights Center (MRC) with some appeals of Medicare Part D plans denying coverage for off-label uses of FDA approved medicines. These denials are based on a very detailed provision in the 2003 Medicare Modernization Act that the Centers for Medicare and Medicaid Services (CMS) interprets to mean that Part D can only cover FDA approved medicines for off-labeled uses that are listed in at least one of three specific compendia.

I became involved with the MRC’s work on this issue because as a Congressional staff person I had helped write a 1993 law that expanded coverage for cancer treatments under Medicare Part B (that’s “B” as in ball) to specifically include off-label uses listed in the compendia OR supported by articles published in peer reviewed literature.…

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Level 4 Bio Lab at Boston University

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Today’s Boston Globe had another report about the delayed opening of the Level 4 research lab at Boston University.  Since it was first proposed and funded, this lab has raised controversy – primarily from those in the community who were concerned about the safety of research involving the most dangerous of organisms occurring in their urban neighborhood. While substantive process (and EPA) concerns have been raised during the building and certification of the lab, the problem really appears to have started from the beginning, with BU seeming to believe that all things biotech-science related are golden, and that their new lab would be welcomed into the neighborhood.…

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