Normally, $15 million a year doesn’t buy you much in the federal government. A notable exception is the Effective Health Care Program at the Agency for Healthcare Research and Quality (AHRQ). Drug manufacturers, device makers, health plans, state Medicaid agencies, Wall Street analysts, physicians, and patient groups should all follow it closely.
The Medicare Modernization Act of 2003 (MMA) authorized AHRQ to conduct and support research on outcomes, comparative clinical effectiveness, and appropriateness of pharmaceuticals, devices, and health care services. With a modest budget, a tiny but dedicated staff, and partnerships with top research institutions, AHRQ’s Effective Health Care Program involves three approaches to research the comparative effectiveness of different medical treatments, drug therapies, and clinical practices:
1. Review and Synthesize Knowledge: AHRQ’s network of 12 Evidence-based Practice Centers systematically review published and unpublished scientific evidence on what is known. Given the huge volume of studies and journal articles produced every year, it is next to impossible for providers, payors, and other key decision makers to keep up and even harder for them to thoughtfully weigh the evidence. AHRQ and its research partners synthesize the science and build a meaningful evidence base.
2. Promote and Generate New Knowledge: The DEcIDE Research Network studies new scientific evidence and analytic tools in an accelerated and practical format. DEcIDE stands for “Developing Evidence to Inform Decisions about Effectiveness.” Comprised of 13 university research centers and think tanks, the DEcIDE network conducts accelerated practical studies about the comparative clinical effectiveness, safety, and appropriateness of specific health care services, drugs, and devices. In other words, what works best for patients.
3. Compile Findings and Translate and Disseminate Knowledge to Decision Makers: AHRQ’s John M. Eisenberg Clinical Decisions and Communications Science Center takes the research results and transform them into into a variety of useful, actionable formats for stakeholders (e.g., providers, payors, purchasers, patients, manufacturers). Specifically, these include (a) consumer guides (short summaries of health care research that can help with decisions about treatments), (b) clinician guides (brief evidence summaries to assist clinical decision making), (c) policymaker guides (short reports of research evidence for use in health care policy making), and (d) white papers on state-of-the-art concepts in health communication.
The past couple years, the initiative has focused on ten priority health care conditions, selected because of their high impact on Medicare, Medicaid, SCHIP, and other federal health programs:
- Arthritis and non-traumatic joint disorders
- Chronic obstructive pulmonary disease and asthma
- Dementia including Alzheimer’s disease
- Depression and other mood disorders
- Diabetes mellitus
- Ischemic heart disease
- Peptic ulcer disease and dyspepsia
- Stroke and hypertension
Later this year, AHRQ will entertain nominations for other priority conditions.
Here’s a sampling of the excellent work already generated. For a directory of these reports, with free access in PDF format, click here:
- Medication Therapy Management Programs in Medicare Part D Prescription Drug Plans
- Comparative Effectiveness of Second-Generation Antidepressants in the Pharmacologic Treatment of Adult Depression
- Efficacy and Comparative Effectiveness of Off-Label Use of Atypical Antipsychotics
- Comparative Effectiveness of Management Strategies for Renal Artery Stenosis
- Comparative Effectiveness and Safety of Analgesics for Osteoarthritis
- Comparative Effectiveness of Epoetin and Darbepoetin for Managing Anemia in Patients Undergoing Cancer Treatment
- Effectiveness of Noninvasive Diagnostic Tests for Breast Abnormalities
- Comparative Effectiveness of Management Strategies for Gastroesophageal Reflux Disease
The Effective Health Care Program has 40 other reports in the works, covering a wide range of topics. These include more comparative effectiveness reviews of specific drugs as well as tools to measure quality, reduce errors, and monitor therapies. To get notified when new research becomes available, sign up for AHRQ’s email list.