BioDesign Roundtable

Seven panelists from the healthcare industry tonight answered the question, "How will Comparative Effectiveness Impact Medical Device Innovation?"

The panelists included:
- Ross Jaffee M.D. of Versant Ventures
- Prof. Alan Garber M.D., Ph.D.
- Robert Pearl M.D. CEO of Permanente Medical Group
- Lewis Sandy M.D. SVP of Clinical Advancement with UnitedHealth Group
- Chip Hance, President of Abbott Vascular
- Prof. Rodney Perkins M.D.
- Dana Mead, Kleiner Perkins Caufield & Byers
- Amit Sinha, MBA of Goldman Sachs


The Health and Human Services website indicates that Comparative Effectiveness Research (CER) funds should:

support research assessing the comparative effectiveness of health care treatments and strategies, through efforts that:
Conduct, support, or synthesize research that compares the clinical outcomes, effectiveness, and appropriateness of items, services, and procedures that are used to prevent, diagnose, or treat diseases, disorders, and other health conditions.
Encourage the development and use of clinical registries, clinical data networks, and other forms of electronic health data that can be used to generate or obtain outcomes data.

The pertinence of this question stemmed from the $1.1 bilion earmark in Obama's American Recovery and Reinvestment Act of 2009 (distributing $787 billion total).

The $1.1 billion consists of:
- $300 million for the Agency for Healthcare Research and Quality
- $400 million for the National Institutes of Health, and
- $400 million for the Office of the Secretary of Health and Human Services

The panel tonight focused on the question of whether this emphasis on CER will impede innovation. The panel seemed to agree that the focus of CER should be on implementation instead of the politics. Robert Pearl of Permanente Group said that systems should focus on infrastructure to link databases for patient information.

"Providers could have no idea if people are getting medication from Wal-Mart or the V.A.," said Pearl.

The panelists agreed that CER should encourage companies to collaborate (especially small and large ones) and improves the infrastructure for research and innovation for quality care.

It is possible companies may pursue a business idea that has found success.

Chip Hance from Abbott did say "what the large company is looking for is some form of predictability."

The panelists agreed that there is a danger that many companies will become "me too" businesses, but Prof. Garber says the healthcare industry needs "me too" companies also.

"Often best drug is the third or fourth on the market, not first," said Garber. "It would be a disaster if we didn’t have competition."

One solution to America's healthcare problems may be the internet, said one panelist, in which patients can give and get daily feedback through personalized care.