Monday, October 3, 2011

Commerical Insurers' Research vs. The Patient Centered Outcomes Research Institute

Government researchers get to work
The Disease Management Care Blog confesses that, from time to time and only when it's alone, it enjoys listening to Taylor Swift, watching cage fighting and taking Newt Gingrich's bombast seriously.  During a typical superlative-laced ("Enormous!"  "Monumental!") New Contract update on CSPAN, the quixotic Presidential candidate pointed out that Medicare (the poster child for government incompetence) will never be able to match the private sector's golden boys Visa and Mastercard's fraud-fighting expertise.  He argues CMS should "outsource" catching crooks.

The Speaker may have a point and it doesn't apply to just fraud.  How about the conduct of research?

Check out this update on the ACA's Patient Centered Outcomes Research Institute, a $3 billion federally-funded not-for-profit "aiming to assist people in making choices that are consistent with the values, preferences and goals" of patients everywhere.  Its Board of Governors and Methodology Committee has been appointed by the GAO, it's been meeting every other month on "framework," "consensus," "priorities," "processes" and "agenda."  It has a mission statement, stakeholders, understanding, speakers bureau and a fix on the landscape that will "inform national priorities." State-of the art methods are currently being reviewed and summarized.

Contrast the progress of this PCORI  baronage with the likes of a 14-plan integrated database involving 33 million persons that can churn out four-year studies like this.  The authors compared the fracture rates of tens of thousands of persons taking 3 different anti-osteoporosis drugs and found one drug appeared to perform better than the two others.  Without the outside interference support of any pharma or government, the authors came up with an important insight that has implications for the coverage of osteoporosis drugs in the commercially insured population.  

While the good intentions and the talent are considerable, the DMCB has to wonder if this slow-motion PCORI suzerainty will ever be able to clearly and efficiently match the research speed and skill of the commercial health insurance industry.  Time will tell, but if the PCORI fails to give taxpayers their money's worth soon, perhaps they should be "Newted" and completely outsourced.

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