QUALITY: Comparative Effectiveness Research--Not Just for Toasters Anymore

Wonder what comparative effectiveness could actually look like? Check out Consumer Reports Best Buy Drugs.

For the past four years, the same folks who help you decide what car to buy and which toaster to purchase, have been putting out independent, unbiased easy-to-understand information to help consumers make informed decisions on what drugs work best for them. After all, if even super-health literate informed patients—like New York Times "Well" columnist Tara Parker-Pope—end up paying for expensive new drugs when cheaper older ones did the job, a bit of objective guidance should help the rest of us. And that means knowing, too, when it's worth spending the extra money on a better medication that will help us heal faster or keep a chronic condition under control.

We got the latest hard copy from our friends at Consumer Union (the parent organization and publisher of the well-known magazine), but the entire project is available online at: www.crbestbuydrugs.org

It's truly amazing. From statins to asthma drugs, Consumer Reports gives a detailed overview of drugs' (generic and brand name) availability, effectiveness, risks and cost. Much of the information comes from research done by the Drug Effectiveness Review Project, a collaboration of academic, private sector and government entities housed at the Oregon Health & Science University, which conducts "systematic, evidence-based reviews of the comparative effectiveness and safety of drugs in many widely-used drug classes."

This being Consumer Reports, they also designate Best Buys that are:

1. As effective as all the other drugs in the category, or more so
2. As safe and cause no more—and usually fewer—side effects than other drugs in the category
3. Cost less on average than other drugs in the category.

The project takes a look at some tough questions, for which there are not always absolutely clear medical answers, such as depression. Should you take an antidepressant? Medication is often overprescribed for situational depression, but only 30 to 40 percent of those suffering from major depression get adequate treatment. The project takes a similarly even-handed approach looking at treatments for menopause, ADHD and a variety of other conditions. The project aims to supplement, not supplant, the expertise and opinions of doctors and pharmacists. The point is not to limit your choices, but to help you make informed ones. As the authors write:

Just to be clear: these aren't the least expensive drugs, they're the best ones-based on comparative medical research in effectiveness, safety, convenience, and side effects.

Americans spent more than $216 billion on prescription drugs in 2006. A recent survey from the Kaiser Family Foundation, showed that more half of American households said they had cut back on medical care because of cost concerns during this economic crisis. Fifteen percent said they had skipped medicine doses or cut their pills in half—a potentially dangerous action.

Projects like Best Buy Drugs can help consumers save money in manner that is safe and effective. It can also help dispel some of the hysteria surrounding comparative effectiveness research that was seen during the stimulus debate. We know what toasters work and which cars handle well in the snow. There are resources to help you decide if you really need a convection oven to cook your morning pop-tart. Shouldn't you be as, if not more, informed when deciding whether or not to get an MRI for your aching back? Comparative effectiveness is not about denying care or limiting good options. It's about helping people get the best care at the best price and that's something we can all subscribe to, even if we don't get home delivery of Consumer Reports.