Comparative Effectiveness

As additional clinical research data is gathered and analyzed, the comparative effectiveness research arena will become increasingly significant to medicine.

The recently passed health care reform law, the Patient Protection and Affordable Care Act (PPACA), creates the Patient-Centered Outcomes Research Institute (PCORI), led by a 21-member board, with additional representation from the Agency for Healthcare Research and Quality (AHRQ) and the National Institutes of Health (NIH). The PPACA also provides a steady funding stream for AHRQ to disseminate research findings from the new institute and from other government-funded comparative effectiveness research.

MITA supports utilizing diagnostically appropriate comparative effectiveness research to improve the quality of health care. Comparative effectiveness research, properly applied, has the potential to lead to earlier diagnosis of disease and earlier, more effective treatment.

However, it is important to understand that for the goals of comparative effectiveness to work for patients, it must emphasize clinical effectiveness rather than only cost effectiveness. While reducing healthcare costs is important, arbitrary reimbursement cuts to life-saving medical imaging devices are not the answer.

For successful comparative effectiveness research to be conducted, it must take into account that diagnostic outcomes should be evaluated differently than therapeutic outcomes. The endpoints of successful diagnosis and successful therapeutic methods are very different and should be treated as such when various medical procedures are being evaluated. Therefore, policymakers and researchers need to understand the unique characteristics of diagnostic procedures and technologies, including those utilizing diagnostic imaging.

MITA supports the goals of comparative effectiveness. However, we must ensure that when properly applied, it does not stymie innovation out of an undue emphasis on cost effectiveness as opposed to clinical effectiveness. MITA looks forward to working with policymakers and PCORI directly to ensure continued access to clinically proven medical imaging and radiation therapy technologies, critical to the diagnosis and treatment of disease.