Minority Advocacy Groups Ask Govt.: Will Comparative Effectiveness Studies Yield Accurate Results?
A significant part of the recently signed stimulus package (at least for people in the health industry) is comparative effectiveness research. Now that the bill has become law, government agencies will be required to conduct large-scale head-to-head clinical trials to determine which prescription medications are truly superior.
Some pharmaceutical industry stakeholders and physicians do not like comparative trials, and their experience with the ALLHAT trial illustrates some of the reasons why. The ALLHAT trial demonstrated that generic blood pressure medications are better than more expensive alternatives. The results sounded good until prominent physician thought leaders began to take the data apart and suggested that the government skewed the study results.
More troubling is that some doctors said the government based the study on poor outcomes experienced by African American patients taking certain types of blood pressure pills. Differences in how people from various ethnic and racial backgrounds respond to medications is one reason minority advocacy organizations are resisting the push to launch more comparative effectiveness studies.
The Congressional Black Caucus expressed concern that “comparative effectiveness research will be based on broad population averages that ignore the differences between patients.” While House and Senate negotiators inserted language in the final bill requiring government-funded trial to include adequate numbers of minorities (and women), some are still concerned that this isn’t enough.
The issue of differences in how people of various racial and ethnic groups respond to medications was a major topic of the interview series I conducted a few years ago focusing on race and medicine. You can read one scientist’s comments about this issue here.
