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Bringing Evidence-Based Medicine to Consumers Alliance for Health Reform January 12, 2005 Gail Shearer Director, Health Policy Analysis Washington Office Consumers Union “Consumer Driven” Health Care? • Is it defined contribution health care in reality? • Adverse segmentation of the health insurance marketplace • Evidence-based medicine should be foundation for universal coverage, comprehensive drug benefits, and improvements in the marketplace as it saves money and rationalizes delivery of care Section 1013: Medicare Modernization Act • Bipartisan effort • Appeals to those who want to provide financial relief • Appeals to those who want to curb federal spending and deficit • AHRQ priorities: constructive first step • Section 1013 calls for findings that are “easily understood” by the public and available both online and in print MISSION: • Information on prescription drugs for consumers and doctors • Increase access to and affordability of needed medicines • Relieve financial burden caused by high drug prices – consumers and businesses METHODS: (1) Drug Effectiveness Review Project • Pioneering work under leadership of former Oregon Governor John Kitzhaber • Partnership (DERP) now includes 12 states and two non-profit organizations • Systematic reviews by AHRQ’s Evidence-Based Practice Centers • Process: transparent, unbiased, rigorous, highly regarded METHODS: (2) Medical Input and Prices • Input from medical consultant • Data on average national retail price paid by cash-paying consumer • CU team reviews effectiveness and cost • Input from CU’s medical advisor, health editorial team, statistician, 2-3 outside medical peer reviewers for each category METHODS: (3) Identifying CR Best Buy Drugs CU team reviews the effectiveness and cost data, and selects one or more drugs that: • Are in the top tier of effectiveness • Have a safety record as good as others in the category • Have an average price substantially lower than the most costly drug in the category CR BEST BUY DRUGS: Cholesterol–Lowering Drugs/Statins For moderate cholesterol reduction: • Generic lovastatin Substantial cholesterol reduction: • Atorvastatin (Lipitor) POSSIBLE ANNUAL SAVINGS: 3 Categories • Statins (cholesterol) $1,300 • Proton Pump Inhibitors: (acid reflux and ulcers) $1,740 • NSAIDs (arthritis and pain) $2,200 Just the beginning … • Continue to draw on DERP reports • One per month • Next up: anti-depressants (SSRIs), high blood pressure and heart disease (ACE Inhibitors and Beta Blockers)