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Institute of Medicine report lists top priorities for comparative effectiveness research: will HIV ARTs be affected in the future
  by Anna Bratulic
June 30, 2009
From Jules: so far HIV ARTs does not appear on this list but will it in the future? The high prices of HIV ART medications could in the future be the target of public and private prescription restrictions and perhaps comparative effectiveness research, where they tell patients and doctors which ART therapies to use, they could perhaps priortize ART medications by price/cost, perhaps use of generics would be required preventing the doctor/patient choice. Over the next 5-8 years several highly prescribed HIV ARTs patents will expire and they could go generic. Will this change formularies and government intervention in dictating which ARTs to use?
A committee of the Institute of Medicine issued a report on comparative effectiveness research for medical treatments which lists 100 priority topics for review. The IOM's list, released Tuesday, includes recommendations to compare treatment strategies in the US for atrial fibrillation, inflammatory diseases, prostate cancer, Alzheimer's disease and attention-deficit hyperactivity disorder, among other health conditions and health-related topics.
The report is intended to provide guidance for spending a portion of the $1.1 billion in economic-stimulus funds provided by the US government for such research. Commenting on the matter, Kathleen Buto, vice president for health policy at Johnson & Johnson, stated that "comparative effectiveness research should inform medical decisions and not replace medical judgement or be used to limit treatment choices." She added that "the ultimate decision about which treatment or intervention is best for a particular individual should remain between a doctor and patient based on real-world data and analyses."
Meanwhile, panel co-chairman Harold Sox, who is also the editor of the Annals of Internal Medicine, said "healthcare decisions too often are a matter of guesswork, because we lack good evidence to inform them." He also remarked that medical-product manufacturers had a "muted" response to the panel's efforts to prioritise the funding, noting that of the approximately 2000 public comments and recommendations the panel received, 28 came from makers of drugs, biologic products or medical devices.
Drugmakers have recently bolstered lobbying efforts aimed at deterring the US government from using comparative drug studies as a possible means of reducing healthcare costs.
Reference Articles
Comparative effectiveness research: A report from the Institute of Medicine - (Annals of Internal Medicine)
J&J, Abbott, Amgen drugs warrant study, IOM says - (Bloomberg)
100 initial priority topics for comparative effectiveness research (pdf) - (Institute of Medicine)
Report brief: Initial national priorities for comparative effectiveness research (pdf) - (Institute of Medicine)
Panel suggests medical priorities for US - (The New York Times)
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