Translating comparative effectiveness research into Medicaid payment policy: views from medical and pharmacy directors

Author:

Weissman Joel S123,Westrich Kimberly4,Hargraves J Lee5,Pearson Steven D6,Dubois Robert4,Emond Sarah6,Olufajo Olubode A17

Affiliation:

1. Center for Surgery & Public Health, Brigham & Women's Hospital, Harvard Medical School, 1620 Tremont Street, Boston, MA 02120, USA

2. Department of Health Policy & Management, Harvard School of Public Health, Boston, MA, USA

3. Department of Healthcare Policy, Harvard Medical School, Boston, MA, USA

4. National Pharmaceutical Council, Washington, DC, USA

5. Center for Survey Research, University of Massachusetts Boston, Boston, MA, USA

6. Institute for Clinical & Economic Review (ICER), Boston, MA, USA

7. Division of Trauma, Burn & Surgical Critical Care, Brigham & Women's Hospital, Boston, MA, USA

Abstract

Background: As the USA seeks to expand the conduct and dissemination of comparative effectiveness research (CER), views of key stakeholders will help guide the way. Methods: We surveyed 60 medical and pharmacy directors from 46 state Medicaid programs. Results: Over 90% felt that CER would lead to better clinical decision-making and overall value within 5 years and were willing to consider cost–effectiveness in setting medical policy. However, perceived poor quality, inconclusive research, restrictive legislative mandates, lack of budget impact and coverage recommendations, and lack of an independent body to interpret study results were major barriers cited to using CER evidence. Conclusion: Given the significant resources being invested in CER, it is critical that these barriers are overcome to maximize its usefulness for stakeholders.

Publisher

Future Medicine Ltd

Subject

Health Policy

Reference15 articles.

1. PCORI. Patient and clinician views on comparative effectiveness research and engagement in research: a panel discussion on PCORI survey results (2013). www.pcori.org/assets/2013/07/PCORI-Patient-Clinician-Views-CER-Engagement-Survey-Webinar-Panelist-PPT-070913.pdf.

2. Five Reasons That Many Comparative Effectiveness Studies Fail To Change Patient Care And Clinical Practice

3. How The Patient-Centered Outcomes Research Institute Can Best Influence Real-World Health Care Decision Making

4. There’s Something About Medicaid

5. A “Customary and Necessary” Program — Medicaid and Health Care Reform

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