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Comparative Effectiveness

Editor’s note: Yes, studies have to be crafted with much thought, professionalism, oversight and independence. As almost any undertaking things can be overlooked, misguided or misused. However, understanding what works for large AND small groups is important in order to provide the best care to people and to keep the costs from rising unnecessarily.

NIH head: personalized medicine at risk with current reform proposals
CHICAGO (Reuters) – The federal government’s push to control health costs through comparative effectiveness research could threaten strides in personalized medicine, in which medicines are tailored to an individual’s genetic makeup, the chief of the National Institutes of Health said on Monday.

“There is a potential collision here,” Dr. Francis Collins, director of the National Institutes of Health said at a forum sponsored by the American Association for the Advancement of Science.

Collins, a genetics pioneer tapped by President Barack Obama in July to head the NIH, said studies that lump together large groups of people to test the effectiveness of treatment A versus treatment B run the risk of overlooking clusters of people for whom a drug might have a dramatic effect.

“That’s going to get lost in the wash by considering everybody equivalent, which we know they are not,” said Collins, who helped lead the Human Genome Project that in 2003 produced a sequence of all the DNA in people.

“The antidote to that is pretty straightforward,” said Collins, saying that studies need to include genetic information that allows researchers to find such responses.

Backers of comparative effectiveness research, who include insurers and large employers, see the government-funded studies as a way to learn which treatments work best. But Collins said the studies should be well crafted.

More of NIH head: personalized medicine at risk with current reform proposals


October 27, 2009 - Posted by | Federal Government, healthcare, Research | , , ,

1 Comment »

  1. Of all the cost related discussions, this topic appears to receive the least attention. The prospect that we might develop custom treatments of considerable effectiveness for small populations distinguished by unique genetic markers generates all sorts of ethical and economic issues. Should the narrow population pay the costs of research and treatment? Will such research even proceed under such circumstances? What corollary benefits that might derive from that research go undiscovered? These are particularly sharp questions in a single payer setting, where the political advantage is in reducing care and expanding coverage for as many current voters as possible, with little regard for the future. Rent seeking then dictates virtually all policy, and, by definition, small constituencies will not see therapies developed for them. The consequences may be relatively dire, but they likely are predictable.

    Comment by Douglas Foss | October 27, 2009 | Reply

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