NPC Annual Stakeholder Survey: Comparative Effectiveness Research Is Important, But Impact on Health Care Decision-Making Is Still on the Horizon

For Immediate Release
Contact: Andrea Hofelich,, 202-827-2078

(Washington, DC, May 19, 2014)—A new survey of health care stakeholders reveals continued optimism for the use of comparative effectiveness research (CER) as a tool for improving health care decision-making, but shows the impact of CER has not yet been realized. The fourth annual survey of CER stakeholders, conducted by the National Pharmaceutical Council (NPC), also indicates that the Patient-Centered Outcomes Research Institute (PCORI), the agency charged with overseeing this research, has firmly established its key role in the CER effort.

“It’s clear from this survey that while expectations around CER’s promise remain strong, the impact is viewed as a future prospect rather than an immediate reality,” said NPC President Dan Leonard. “However, the work of PCORI and other entities in key areas has translated into some notable shifts in perceptions among stakeholders, suggesting that the work being done in the CER field is being closely watched by those most likely to be impacted.” 

According to the survey, while 59 percent of respondents felt CER was “very important,” the majority of respondents (84 percent) felt CER had little impact on health care decision-making in the past 12 months. Rather, confidence in CER’s potential increases with the time horizon. Thirty-one percent of respondents said CER will have a “moderate improvement” on health care decision-making over the next 12 months, which is unchanged from last year. Respondents felt more confident about the impact of CER on health care decision-making over the next three to five years, with a “moderate improvement” indicated by 56 percent and 50 percent, respectively, and a “substantial improvement” indicated by 21 percent and 42 percent, respectively.

The survey captures stakeholder perceptions of key CER players. Consistent with 2013 findings, survey respondents named PCORI as the leader in establishing research priorities over the next five years (76 percent), followed by the National Institutes of Health (NIH) (66 percent) and the Agency for Healthcare Research and Quality (AHRQ) (62 percent). These findings may reflect PCORI’s increased engagement with the general public, broad calls for research projects and millions of dollars awarded for research.

In other research areas, respondents provided insights on leadership and roles in key activities:

  • Stakeholders expect AHRQ (71 percent) and PCORI (70 percent) to play the most significant role in establishing CER standards over the next five years.
  • When it comes to funding and monitoring research, stakeholders see prominent roles for NIH (77 percent) and PCORI (76 percent), representing PCORI’s growing footprint in the landscape.
  • Respondents say the actual work in conducting research is still expected to fall overwhelmingly to academia (85 percent) and the pharmaceutical industry (65 percent), mirroring findings from the previous four years.
  • In a new question posed in the 2014 survey regarding which stakeholders will take the lead in translating and disseminating research, respondents view AHRQ (80 percent) as the leading entity, followed by academia (72 percent) and PCORI (69 percent). 

The survey also captured notable shifts in stakeholders’ understanding of the CER environment.

  • Forty-seven percent of respondents believe that we are trending toward having more widely agreed-upon research standards for CER. Having widely agreed-upon standards would provide more consistency in the conduct of CER.
  • Thirty-seven percent of respondents felt that research priorities adequately address treatment choices faced by patients and providers, up from 22 percent last year.

Three new questions also were added to the 2014 survey. When asked whether the existing CER evidence base is “complete enough to inform the choices faced by patients and providers,” 67 percent said there is not enough evidence available. When asked whether real-world evidence is used to inform health decisions, 47 percent of stakeholders said the use of this evidence is limited. Additionally, 47 percent of respondents felt that the variability in individual patient response tends not to be considered when making coverage or treatment decisions.   

“The survey provides an important look at how perceptions of CER have shifted during the implementation of the Affordable Care Act,” said Kimberly Westrich, director for health services research for NPC. “It will be important to track how CER comes to fruition, and the real impact it has on informing treatment decisions, as well as on coverage and access to treatments.” 

The survey, conducted by Scientific & Social Systems on behalf of NPC, was fielded between September 13, 2013, and January 31, 2014, among key stakeholders who are knowledgeable about CER, including researchers/thought leaders; government; insurers/health plans; employers; business coalitions; and associations. A total of 110 stakeholders participated.

The complete survey results, instrument and booklet are available on NPC’s website at

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 and follow NPC on Twitter @npcnow.

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