Highlights of the Session on the Role of Purchasers in the Clinical Research Enterprise

What do purchasers need from the Clinical Research Enterprise?

  • Purchasers need research that can inform benefit design decisions as well as research that sheds light on what they can do to better understand clinical variation and to implement programs that address inappropriate variation. They need to know which new technological innovations and treatments have been proven efficacious through high-quality empirical evidence. They need further research to help them put incentive programs into place that support clinical quality and efficiency.

  • Studies providing such evidence must be well designed, well executed, and published in peer-reviewed journals. To make budgetary room for new technology and treatments, the Clinical Research Enterprise must apply rigorous standards of evidence to identify and drive out ineffective or less-than-effective treatments or technology. The Clinical Research Enterprise needs to address the blocks in translating basic research findings into clinically meaningful recommendations and in translating those recommendations into action.

  • Purchasers need to understand why agreed-upon clinical practices are not always performed. They need to know why there is wide variation in clinical practice and what solutions can be developed collaboratively to reduce this variation.

  • Purchasers are concerned about rising pharmaceutical costs and need unbiased comparisons of new versus existing therapeutic agents.

  • The Clinical Research Enterprise needs to encourage physicians and hospitals to incorporate current technology into their practices.

  • The Clinical Research Enterprise needs to provide a mechanism for fast-track review for priority research issues.

  • The Clinical Research Enterprise must provide better protection against genetic discrimination in insurance coverage and in the workplace.

What are purchasers willing to contribute to the Clinical Research Enter prise?

  • Purchasers help disseminate information to consumers on best clinical practices, and they reward hospitals, physicians, and others who are willing to meet best-practice standards.

  • Purchasers are willing to pay for quality in health care, but they need to know what they will receive for their investment.

  • Some purchasers participate in partnerships with researchers, physicians, and pharmaceutical manufacturers; such efforts can provide guidance on realignment of incentives for providers and employees.

  • In the shift to a consumer-driven health care system, purchasers can play a role in preventive health by educating their members and encouraging healthy lifestyle behaviors.

  • Purchasers may be interested in contributing to a national fund used to examine research questions of national significance, but they need to know what the return would be for the investment.



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