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AHIP Wants Medical Procedure Evaluation Agency

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Board members of America’s Health Insurance Plans say the government should do more to evaluate the safety and efficacy of medical procedures and technologies that are already on the market.

The Food and Drug Administration evaluates new drugs and technologies, but it is not responsible for determining how well the drugs and technologies really work in practice, according to the board of AHIP, Washington.

“Americans need a trusted source from which they can get up-to-date, objective and credible information on which health care services are most effective and provide the best value,” the AHIP board members write in their proposal.

The new entity, which could be known as the “Comparative Effectiveness Board,” could compare existing drugs, devices, procedures, therapies and other health care products and services, the board members write.

The board could be especially useful in resolving painful controversies about the value of procedures such as autologous bone marrow transplants and use of arterial stents, the board members write.

In addition, Congress should make sure the FDA has the authority to monitor the long-term effects of new drugs, devices and biologicals, and the U.S. Department of Health and Human Services should do more to make sure that researchers are filling obvious gaps in evidence about how well various treatments really work.

Another important step is improving systems for screening out frivolous medical malpractice claims and streamlining the current tort system for claims that do have merit, the AHIP board members write.

“States should enact programs which promote the use of early-offer settlements granting immunity from tort liability to providers who make settlement offers acceptable to injured patients and agree to pay reasonable compensation within specified timeframes,” the board members write. “Early-offer settlements would resolve disputes expeditiously and avoid costly trials.”

Simply promoting evidence-based medicine would help reduce the number of malpractice disputes, as well as improve the quality of care, AHIP representatives and others said here today at a press conference held to announce the AHIP board’s proposal to strengthen the health care system.

The Comparative Effectiveness Board would be especially helpful, speakers said.

“We need a place to do comparative analysis,” said AHIP President Karen Ignagni.

Dr. Roberta Herman, chief medical officer at Harvard Pilgrim Health Care, Wellesley, Mass., agreed.

Providers “need to find out what works and what doesn’t,” and providing care “can’t just be about what works in a highly controlled lab environment,” Herman said.

One of the problems facing the health care industry is that many evidence-based best practices are not being reported to providers and therefore are not being widely used, Ignagni said.

One study found that about 45% of health care procedures are not being conducted using best practices, Ignagni said.

“We have the best research apparatus in the world” in the National Institutes of Health, she said, “but we have not spent a concomitant amount to diffuse” the data that has resulted.

Given providers’ demanding schedules and the volume of data being released, expecting providers to seek out the current research and data on their own would be unfair, Ignagni said.

After working all day, providers “can’t be expected to go home and digest 15 or 20 medical studies,” Ignagni said.

Dr. Lewis Sandy, senior vice president at UnitedHealth Group Inc., Minnetonka, Minn., praised the AHIP board effort to improve the health care system.

All of AHIP’s recommendations are “prudent, doable and timely proposals,” Sandy said.