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The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union AHRQ 2007 Annual Conference September 27, 2007. Case study: How comparative-effectiveness research can benefit consumers and taxpayers. - PowerPoint PPT Presentation
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The Use of Comparative Effectiveness ResearchIn Decision Making
~
Gail ShearerConsumers Union
AHRQ 2007 Annual Conference
September 27, 2007
• Case study: How comparative-effectiveness research can benefit consumers and taxpayers.
• What made our project possible: Drug Effectiveness Review Project (OHSU; basis for Medicaid drug decisions by participating states)
• Powerful model that can be expanded.
About Consumer Reports
• Trusted source of objective information since 1936
• Accepts no advertising and is independent of all commercial interests including drug companies
• Independent• Non-profit
Mission:• Provide unbiased in-depth
information on prescription drugs for consumers and doctors
• Increase access and affordability to needed medicines
• Relieve financial burden caused by high drug prices
Goals for Consumers
• Provide them with objective information on effectiveness of prescription drugs
• Help them open a discussion about drug costs with their doctor
• Help them afford the medicines they need (copayments, donut, uninsured)
Identifying CR Best Buy Drugs
• Start with credible source of unbiased, rigorous analysis of clinical evidence about drug effectiveness (DERP)
• Intense medical input through consultants, internal CU review, and medical peer review
• Selections based on effectiveness, safety record, and price
Present Information in Easy to Use Format
(back side of 2 page report)
The Statins
• Introduction of generics: changing marketplace• Huge stakes: $8 billion for Medicare beneficiaries
alone• Major health consequences of greater
affordability
Possible Annual Savings: 5 Categories
• Statins $1,300 (cholesterol)• Proton Pump Inhibitors: $2,000 (acid reflux and ulcers)• NSAIDs $2,200 (arthritis and pain)• Anti-depressants $1,200• Beta Blockers $1,900
(high blood pressure)
M o n t h l y C o s t s o f E q u a l l y E f f e c t i v e D r u g C h o i c e s : N S A I D s , A n t i d e p r e s s a n t s , A C E I n h i b i t o r s , 2 0 0 5
$ 9
$ 1 6 8
$ 1 6
$ 7 7
$ 2 4
$ 1 7 1
$ 0
$ 2 0
$ 4 0
$ 6 0
$ 8 0
$ 1 0 0
$ 1 2 0
$ 1 4 0
$ 1 6 0
$ 1 8 0
Ib u p r o fe n C e l e b r e x F l u o x e t i n e Z o l o ft P r i l o s e c O T C N e x i u m
N S A I D s A n t i d e p r e s s a n t s P r o t o n P u m I n h i b i t o r s
Mo
nth
ly C
ost
Medicare Part D: Cost Implications of Switching to Cost-Effective Drugs
January 2006
$216
$949$1,302
$2,771
$4,814
$6,335
$0
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
$7,000
Lowest Cost Plan
To
tal
An
nu
al
Dru
g C
osts
Best Buy Drugs
Alternate Drugs
Average Cost Plan
Highest Cost Plan
Outreach and Intermediaries
• Six states (GA, CA, AZ, MN, MD and PA)• Pharmacists, Doctors, Libraries, Senior
groups, Employer and Employee Organizations
• Recruit your doctor campaign• Agreement with Medco• Project with WEA Trust• Outreach to doctors through Tarascon
Early lessons from our outreach efforts:• Consumers have different needs• Need to work through trusted
intermediaries• Importance of trustworthy sources • Learn more about how to communicate
with consumers• Remember those without Internet access
WEA Insurance Trust
• 2nd largest health insurer in Wisconsin (non profit, public education employees and families)
• Conducted informational campaign directed to beneficiaries using Proton Pump Inhibitors (PPIs): -- sustained increase in market share of Prilosec OTC-- Individual out-of-pocket costs reduced $36,000--$455,000 in savingsto the Trust
Best Buy Drug Reports on Pocket Pharmacopoeia – PDA
Reference
Change the information model from:
To:
unbiased, evidence-based information