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Troubles WIth Stimulus Report Language

January 21, 2009 - by Donny Shaw

This caught my eye, from Congress Daily ($):

>House Appropriations Chairman David Obey set off a firestorm recently by including report language for the House economic stimulus package that implied that $1 billion to fund research to compare the effectiveness of medical treatments would keep patients from more-expensive medications and procedures — and even staffers who crafted the bill language are fuming over the report.
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>"The trouble is not with the legislative language, which was carefully crafted with all relevant committees in both chambers to be neutral on cost and coverage issues. It is the draft report language that has raised concerns," one House Democratic aide said. “Many people who are committed to advancing [comparative-effectiveness research] would like to see it changed to better reflect the intent of the actual legislative language before this process is over.”
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>According to Obey’s report language, “By knowing what works best and presenting this information more broadly to patients and healthcare professionals, those items, procedures, and interventions that are most effective to prevent, control, and treat health conditions will be utilized, while those that are found to be less effective and in some cases, more expensive, will no longer be prescribed.”
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>Opponents and even some proponents of comparative effectiveness research fear government use of the outcomes of certain research will affect patient access to treatments when the results are used for coverage determinations.
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>"[The stimulus bill] basically could lead to singling out one particular drug for a formulary," Rep. Jo Ann Emerson, R-Mo., said. Emerson introduced comparative-effectiveness research legislation in the previous Congress but does not support the stimulus language.
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>The report language further aggravated those who are typically against any comparative-effectiveness research that could be applied to coverage, including pharmaceutical and biologic drugmakers, as well as some health policy experts.

Here’s a link to download the full report text, and here’s the full bill text (comparative-effectiveness research language occurring on pages 158-60).

Though committee reports, like this one, don’t actually carry the weight of law, they are used by the executive departments and courts as authoritative resources for understanding the purpose and meaning of legislation. Obey’s report language could have a strong impact on how the legislation is carried out by the Department of Health and Human Services.

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