Wednesday, April 24, 2013

An Insider's Look at Comparative Effectiveness Research

Patrick Monaghan
JSPH Director of Communications

The Jefferson community was treated to true insider’s look at comparative effectiveness research last week when Robert W. Dubois, MD, PhD, visited campus to speak at the Jefferson School of Population Health Forum.

Dr. Dubois is the Chief Science Officer at the National Pharmaceutical Council, where he oversees NPC’s research on policy issues related to comparative effectiveness research, as well as how health outcomes are valued.

During his talk at Jefferson, “Applying Comparative Effectiveness Research and Evidence-Based Medicine to Everyday Decisions,” Dr. Dubois provided a simple definition for CER (“CER is what works, for whom, under what circumstances”); described the evidence needed to guide decisions; discussed concerns that evidence is not being used well, and outlined examples of policies impacting individual treatment, evolving payment environment, and use of real-world evidence.

“What I’m hoping is that I’ll open your eyes to some of these choices so that we collectively choose wisely,” Dr. Dubois said. “Once you’ve figured out what to do, you have to do it. None of this is going to work if we don’t make it embedded in how we make choices.”

CER, Dr. Dubois said, if you do it narrowly -- drug A vs. drug B, therapy A vs. therapy B, and looking at the cost of those interventions “you’re going to get it wrong more often than you’re going to get it right.” Policy implications, he noted, are extremely important in the CER world.

Following Dr. Dubois’s talk, members of the School of Population Health’s Grandon Society were invited to remain for a private question and answer session, which led to interesting discussions about bundled payments, rapid-cycle learning in healthcare systems, and the Patient-Centered Outcomes Research Institute(PCORI).  Asked about the political reality of bundled payments, Dr. Dubois replied “I think it’s a reality; the American public is running with the concept,” pointing out that 10 percent of American patients are in accountable care organizations (ACOs), which reward doctors and hospitals for working together to improve quality and to control costs.

Asked about his “take” on bundled payment systems, Dr. Dubois offered, “A lot of this is religion, it’s belief. I, in my core, believe this is the right way to go.”

The audio portion of Dr. Dubois JSPH Forum presentation is available on Jefferson Digital Commons  by clicking here.