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and based at the Oregon Health & Science University has said there have been no long-term trials, and many of those trials that have taken place were laced with conflicts of interest. It recommends more comparative studies and restricting use for now.
• The U.S. has no official oversight agency like the National Institute for Health and Care Excellence (NICE) in the U.K., which evaluates new drugs and technologies and makes recommendations to the National Health Service. NICE will complete its review in the fall. Meanwhile the British health service is paying the equivalent of $32 million to treat 500 of the sickest patients.
• There's zero chance the U.S. will adopt a NICE-like organization any time soon. The Affordable Care Act prohibits the Patient-Centered Outcomes Research Institute, created by the ACA, from considering costs when it evaluates the effectiveness of various treatments. And Medicare is not allowed to consider cost in deciding whether to cover a drug or a device. The government's hands are tied.
• Rother's group will have to figure out a way to evaluate cost and effectiveness within the health system's political boundaries. That won't be easy, and the drug industry is pushing back. Drug makers want the government to make insurers absorb the extra cost rather than passing them along to patients in the form of higher copays and coinsurance for those who need the drug.
• That's not really a solution, Rother says. "High-cost drugs raise premiums and threaten funding for important health services. Ultimately the individual pays the costs one way or another. The fundamental problem is the unnecessary high prices of some drugs, not which pocket the consumer uses to pay for them."
• Editor's note: The Rural Health News Service is funded by a grant from The Commonwealth Fund and distributed through the Nebraska Press Association Foundation, the Colorado Press Association and the South Dakota Newspaper Association.
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