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Information on Cost-Effectiveness: An Essential Product of a National Comparative Effectiveness Program

American College of Physicians
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* This paper, written by Neil Kirschner, PhD; Stephen G. Pauker, MD; and Joseph W. Stubbs, MD, was developed in part for the Medical Services Committee of the American College of Physicians (ACP): Joseph W. Stubbs, MD (Chair); Mary M. Newman, MD (Vice Chair); Peter Basch, MD; Yul D. Ejnes, MD; Jeannine Z. Engel, MD; Stephen D. Fihn, MD, MPH; Susan H. Gunn, MD; William R. Hersh, MD; Michael D. Lahey, MD; J. Leonard Lichtenfeld, MD; Eric M. Mazur, MD; Stephen G. Pauker, MD; and Michael C. Sha, MD. Approved by the ACP Board of Regents on 13 January 2008.

Ann Intern Med. 2008;148(12):956-961. doi:10.7326/0003-4819-148-12-200806170-00222
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The American College of Physicians recently highlighted the need to provide increased information comparing the effectiveness of health care interventions to ensure the rational and effective practice of medicine. Comparative effectiveness refers to the evaluation of the relative clinical effectiveness, safety, and cost of 2 or more medical services, drugs, devices, therapies, or procedures used to treat the same condition. The College further recommended the establishment of an adequately funded, trusted national entity that should prioritize, sponsor, or produce both comparative clinical and cost-effectiveness data.

This article addresses the need for the proposed entity to develop cost-effectiveness information. It examines the current reluctance to develop and use cost-effectiveness in the United States; it argues for the importance of this information for all health care stakeholders; and it makes specific recommendations regarding how this information can best be made available and used for the good of the public and our patients.





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