NPC Survey of Health Care Stakeholders Indicates Cautious Optimism About Use of Comparative Effectiveness Research in Decision-Making

PCORI Growing in Importance, But AHRQ, NIH Still Lead on Research Standards, Funding

(Washington, DC, March 27, 2012)—A new survey of health care stakeholders shows that there is cautious optimism about the impact of comparative effectiveness research (CER) on health care decision-making and that recognition is continuing to grow for the Patient-Centered Outcomes Research Institute (PCORI)--the agency charged with overseeing this research. The 2012 survey, the second in an annual series conducted by the National Pharmaceutical Council, examined stakeholder opinion on CER and the current environment for health care decision-making.

“The findings reflect a more pragmatic view about how CER will be used and who will be funding it,” said NPC President Dan Leonard. “It’s clear from this second survey that stakeholders view CER with increasing importance, but they do not believe it has had a significant impact on health care decisions to date.”

Despite the growing recognition for PCORI’s role in CER, the Agency for Healthcare Research and Quality (AHRQ) and the National Institutes of Health (NIH) are viewed by surveyed stakeholders as the leading agencies for establishing priorities, and for funding and monitoring research. Stakeholders do expect PCORI to play an important role, however: although more than 80 percent of respondents believe that AHRQ will be influential in establishing research standards, 72 percent indicated a significant role for PCORI, compared to only 50 percent in the 2011 survey. Two-thirds of current respondents also expect PCORI to have an impact on establishing research priorities, and 60 percent note PCORI’s position in funding and monitoring research.  As for who will be doing the actual research—respondents believe that job will fall overwhelmingly (88 percent) to academics, with the pharmaceutical industry as their next choice (70 percent). Industry also is expected to play a significant role in funding and monitoring research, said two-thirds of respondents.

From 2011 to 2012, stakeholders who were surveyed indicated that they are slightly more optimistic about the momentum around CER yielding availability of new research methods (9 percent in 2011 to 14 percent in 2012) and agreed-upon standards for effectiveness research (10 percent to 14 percent). Stakeholders also thought that there was more transparency and objectivity in interpreting CER evidence (8 percent to 19 percent).

Stakeholders showed flat or lower expectations in other areas. They believe there is a lack of consistent and transparent standards for exchange of medical information (32 percent to 36 percent), and that there is a narrow focus on clinical effectiveness for treatment assessments without consideration of broader measures of value (26 percent to 39 percent).  Survey respondents also showed they were no more optimistic than a year ago that real-world research priorities reflect the choices patient and providers face (11 percent to 12 percent).

“It’s interesting that as the more granular issues have begun to emerge, we’re seeing that expectations for CER to impact health care decision-making are largely positive, but not universally rosy,” said Dr. Claudia Schur, director and vice president of the Center for Health Research & Policy at Social & Scientific Systems. “There are mixed expectations among stakeholders when it comes to the overall CER environment.”

The survey, conducted by Social & Scientific Systems on behalf of NPC, was fielded between October 2011 and February 2012 among key stakeholders impacted by CER, including government, researchers, insurers, employers, human resource consultants, health care coalitions, and trade and other groups. A total of 117 stakeholders participated.

View the complete survey results and instrument on NPC’s website.

About the National Pharmaceutical Council

The National Pharmaceutical Council is a health policy research organization dedicated to the advancement of good evidence and science and to fostering an environment in the United States that supports medical innovation. Founded in 1953 and supported by the nation’s major research-based pharmaceutical companies, NPC focuses on research, development, information dissemination, and education on the critical issues of evidence, innovation and the value of medicines for patients. For more information, visit www.npcnow.org and follow NPC on Twitter @npcnow.

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