the use of comparative effectiveness research in decision making ~ gail shearer consumers union

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The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union AHRQ 2007 Annual Conference September 27, 2007

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The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union AHRQ 2007 Annual Conference September 27, 2007. Case study: How comparative-effectiveness research can benefit consumers and taxpayers. - PowerPoint PPT Presentation

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Page 1: The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union

The Use of Comparative Effectiveness ResearchIn Decision Making

~

Gail ShearerConsumers Union

AHRQ 2007 Annual Conference

September 27, 2007

Page 2: The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union

• Case study: How comparative-effectiveness research can benefit consumers and taxpayers.

• What made our project possible: Drug Effectiveness Review Project (OHSU; basis for Medicaid drug decisions by participating states)

• Powerful model that can be expanded.

Page 3: The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union

About Consumer Reports

• Trusted source of objective information since 1936

• Accepts no advertising and is independent of all commercial interests including drug companies

• Independent• Non-profit

Page 4: The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union

Mission:• Provide unbiased in-depth

information on prescription drugs for consumers and doctors

• Increase access and affordability to needed medicines

• Relieve financial burden caused by high drug prices

Page 5: The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union
Page 6: The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union

Goals for Consumers

• Provide them with objective information on effectiveness of prescription drugs

• Help them open a discussion about drug costs with their doctor

• Help them afford the medicines they need (copayments, donut, uninsured)

Page 7: The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union

Identifying CR Best Buy Drugs

• Start with credible source of unbiased, rigorous analysis of clinical evidence about drug effectiveness (DERP)

• Intense medical input through consultants, internal CU review, and medical peer review

• Selections based on effectiveness, safety record, and price

Page 8: The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union

Present Information in Easy to Use Format

(back side of 2 page report)

Page 9: The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union

The Statins

• Introduction of generics: changing marketplace• Huge stakes: $8 billion for Medicare beneficiaries

alone• Major health consequences of greater

affordability

Page 10: The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union

Possible Annual Savings: 5 Categories

• Statins $1,300 (cholesterol)• Proton Pump Inhibitors: $2,000 (acid reflux and ulcers)• NSAIDs $2,200 (arthritis and pain)• Anti-depressants $1,200• Beta Blockers $1,900

(high blood pressure)

Page 11: The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union

M o n t h l y C o s t s o f E q u a l l y E f f e c t i v e D r u g C h o i c e s : N S A I D s , A n t i d e p r e s s a n t s , A C E I n h i b i t o r s , 2 0 0 5

$ 9

$ 1 6 8

$ 1 6

$ 7 7

$ 2 4

$ 1 7 1

$ 0

$ 2 0

$ 4 0

$ 6 0

$ 8 0

$ 1 0 0

$ 1 2 0

$ 1 4 0

$ 1 6 0

$ 1 8 0

Ib u p r o fe n C e l e b r e x F l u o x e t i n e Z o l o ft P r i l o s e c O T C N e x i u m

N S A I D s A n t i d e p r e s s a n t s P r o t o n P u m I n h i b i t o r s

Mo

nth

ly C

ost

Page 12: The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union

Medicare Part D: Cost Implications of Switching to Cost-Effective Drugs

January 2006

$216

$949$1,302

$2,771

$4,814

$6,335

$0

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

$7,000

Lowest Cost Plan

To

tal

An

nu

al

Dru

g C

osts

Best Buy Drugs

Alternate Drugs

Average Cost Plan

Highest Cost Plan

Page 13: The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union

Outreach and Intermediaries

• Six states (GA, CA, AZ, MN, MD and PA)• Pharmacists, Doctors, Libraries, Senior

groups, Employer and Employee Organizations

• Recruit your doctor campaign• Agreement with Medco• Project with WEA Trust• Outreach to doctors through Tarascon

Page 14: The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union

Early lessons from our outreach efforts:• Consumers have different needs• Need to work through trusted

intermediaries• Importance of trustworthy sources • Learn more about how to communicate

with consumers• Remember those without Internet access

Page 15: The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union
Page 16: The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union
Page 17: The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union

WEA Insurance Trust

• 2nd largest health insurer in Wisconsin (non profit, public education employees and families)

• Conducted informational campaign directed to beneficiaries using Proton Pump Inhibitors (PPIs): -- sustained increase in market share of Prilosec OTC-- Individual out-of-pocket costs reduced $36,000--$455,000 in savingsto the Trust

Page 18: The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union

Best Buy Drug Reports on Pocket Pharmacopoeia – PDA

Reference

Page 19: The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union
Page 20: The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union
Page 21: The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union

Change the information model from:

Page 22: The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union

To:

unbiased, evidence-based information

Page 23: The Use of Comparative Effectiveness Research In Decision Making ~ Gail Shearer Consumers Union