Healthcare Bill Creates New Research Center

Most of the publicity on the widely debated Patient Protection and Affordable Care Act has failed to mention one of its most interesting mandates, namely the creation of a new center for comparative research.

Section 6301 of the bill establishes an independent, not-for-profit corporation, the Patient-Centered Outcomes Research Institute (PCORI)

“to assist patients, clinicians, purchasers, and policy-makers in making informed health decisions by advancing the quality and relevance of evidence concerning the manner in which diseases, disorders, and other health conditions can effectively and appropriately be prevented, diagnosed, treated, monitored, and managed through research and evidence synthesis that considers variations in patient subpopulations, and the dissemination of research findings with respect to the relative health outcomes, clinical effectiveness, and appropriateness of the medical treatments, services, … “

In other words, the institute will conduct research to find out which drugs are the most effective at treating a particular disease. This could be extremely useful because several recent studies have shown that the newest and most expensive drugs are not always the best treatment. For example, one study published in the Journal of the American Medical Association found that water pills were better at treating hypertension than ACE inhibitors and calcium channel blockers, which cost 30 times more than a simple water pill. However, since drug companies have short-lived patents on their products, they have a huge financial incentive to make new drugs, that can be patent-protected, to replace those old ones. In order to get FDA approval for a new drug, companies have to prove a laundry list of things, including effectiveness and safety, but not that their new drug is better than drugs developed several decades ago. They simply have to show their drug is better than a placebo.

Since there is no financial incentive for a pharmaceutical company to conduct such comparative research between their new products and older ones, these studies are not typically conducted by the drug industry. However, such research, if truly done objectively and scientifically on a large scale, could have a huge impact on healthcare costs. It could keep the drug companies from wasting resources on drugs that aren’t any better than what is already available.

In academia, the question everyone has to answer about their chemistry research is: “How is your method of doing X better than the methods already out there?” It isn’t enough to just be doing something different and new, it has to be better. How often academic research lives up to that standard is debatable, but still the question is important to ask of all scientific research. Just because Pfizer can develop a new drug to treat cholesterol doesn’t mean they should. It is only truly a valuable scientific contribution if the new drug is better than those already on the market.

Overall, we think the creation of a comparative research center could potentially lower healthcare costs. We think it could help promote better drug discovery by essentially creating a peer-review process for new drugs and therapies. Also, we imagine that this center will create many new jobs for scientists, which is good news for all of those out-of-work or underemployed chemists out there.

Interestingly, the U.K. already has a center similar to this called the National Institute for Health and Clinical Excellence (NICE). We imagine that is where Obama got the idea for the center in the first place.

Photo source: slideworld.com

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