Managed Healthcare Executive - March 2009 - (Page 6) NEWS ANALYSIS “Down payment” from page 5 insurers are looking to HHS to develop workable regulations that support an interoperable health IT system. Even more controversy surrounded the debate over establishing a federal program to fund comparative e ectiveness research to gather data on which treatments and medical procedures are most e ective in patient care. There is broad support from plans and payers for developing such unbiased expert evidence, which would ideally prompt doctors to order appropriate treatments and would reduce spending on ine ective proce- dures and products in the process. However, pharmaceutical and medical device companies objected, saying that the CE program would condemn high-tech, high-cost products and ignore di erences in individual response to any treatment. Initial language accompanying the House bill promised payo s of CE research, citing that less-e ective and more-expensive products “will no longer be prescribed,” thus stoking fears of government rationing. In the end, the CE research provision carried language specifying that there is no intent to use research data to mandate coverage, reimbursement or other payer policies, or to establish one-size- ts-all treatment protocols. The same provisions apply to the new Federal Coordinating Council for CE Research, which is supposed to set the CE research agenda. It’s generally understood that CE assessments funded by AHRQ and NIH will carry considerable weight and support coverage and reimbursement decisions by Medicare and insurers. Payers want CE research to consider costs, which is not prohibited in the bill. MHE Transparency takes ight TRACEY WALKER SENIOR EDITOR NATIONAL REPORTS — Drug manu- facturers, including Eli Lilly, P zer and Merck, are becoming more transparent about their nancial dealings with physicians and researchers. “Improved transparency of clinical research is a natural part of the larger sea change, where the buyer side of healthcare expects and needs transparency of provider performance,” says Kip Piper, senior counselor at Fleishman-Hillard and president of Health Results Group, a Washington, D.C. consultancy. “In physician and hospital reporting, the focus is on the value and the performance of the responsible decision makers, not the dollars they are paid,” Piper says. “[Drug manufacturers] are following the same sensible approach for clinical research. Users of clinical research need to know who the sponsors are, but ultimately we must keep our eyes on the value studies o er. We need more published clinical research, not less.” Aetna welcomes drug manufacturers’ transparency e orts, says Wendy Morphew, Aetna spokeswoman. “While we would not necessarily discount the results of industry-sponsored 6 MARCH 2009 studies, it is helpful to know whether there has been industry funding in order to assess any bias in the study design or reporting of results. It is also useful to know whether clinicians who participated in the creation of guidelines or consensus statements have nancial interests in the products they are promoting,” Morphew says. Piper adds that research must be actionable, decision-relevant, timely, translated, as well as widely disseminated. “Transparency should be the same. Simply put, information decision makers need to make decisions, including assessing the value and relevance of published studies,” he says. TRUST DRIVES TRANSPARENCY Disclosures by pharmaceutical manufacturers may be fueled by growing litigation and a wary public, says Jake Wengro , spokesman for Frost & Sullivan, a growth consulting rm based in Mountain View, Calif. “Rising healthcare costs in a recession have left most consumers with the sensation that the drug companies have lost their commitment to improving patient outcomes,” Wengro says. “These new disclosures will give patients a deeper understanding of how drugs are developed, encouraging patients to ask their doctors if the prescribed medication is absolutely necessary.” Perceptions about compensation to physicians and in uence in the medical community are clearly barriers to trust, says Lilly spokeswoman Angela Sekston. “We absolutely believe that championing these ‘transparency rsts’ will help build trust,” she says. “With [our] physician registry in particular, we will be opening up for public viewing a part of business that some have been highly skeptical of.” Managed care executives may require greater disclosure, deeper than what the pharmaceutical companies plan to release to the public, says Wengro . “A managed care program may nd itself with a public relations nightmare if it is later disclosed that it negotiated higher rates for particular drugs that earlier were shown to be well funded with payments to doctors and researchers,” he says. Hopefully, “the ultimate goal will be the adoption of consistent guidelines and reporting practices by all pharmaceutical manufacturers, regardless of their specialization or segment,” says Robert Taketomo, PharmD, MBA, president and CEO of Ventegra in Glendale, Calif. MHE Imagezoo/Images.com/Getty Images
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