Drugs, Surgery or Physical Therapy?
On February 17th the New England Journal Of Medicine spoke about the American Recovery and Reinvestment Act of 2009 ($787 billion economic stimulus package) in a column by Robert Steinbrook, M.D...
"On the medical research front, comparative effectiveness studies that directly compare the risks and benefits of different treatments for a particular condition are essential for improving practice and slowing cost escalation.Pharmaceutical and Medical Device Industries wont pay?
Such studies, however, have been controversial; the pharmaceutical and medical device industries may not fund them, and some are concerned that the government or insurers may use the results to mandate specific approaches to treatment or to deny coverage."
Are they afraid of a side-by-side outcomes and cost-effectiveness comparison to physical therapy?
They are afraid of a mandate?
Should exercise or conservative care be mandated prior to spinal surgery for lower back pain?
The Act anticipates this concern by saying that the funds will not be spent to...
"mandate coverage, reimbursement, or other policies for any public or private payer."Mandates or not, expect changes in health care policies and priorities from the sudden wave of money, most of which will be spent within two years.
"...the $1.1 billion in new funding for comparative effectiveness research dwarfs the current $334 million annual budget of the Agency for Healthcare Research and Quality."But then, we should be used to change by now.