Fascinating article from the Associated Press titled, "What's the best medicine really?" in which a government panel will try to determine which therapies and medications are better than others in a study of "comparative effectiveness". Funded by the stimulus package passed by Congress, about $1.1 billion will be spent understanding this.
Naturally, all parties involved have a stake in this because there will be losers. Although the article states that it is a secret that newer medications don't need to be better than older proven therapies, that isn't true. It's that the public is unaware that for FDA approval, medications only need to be better than placebo.
Pharmaceutical companies rarely do comparative effectiveness studies because they can backfire. Note how Bristol-Myers Squibb compared its cholesterol lowering medication PRAVASTATIN against Pfizer's ATORVASTATIN (LIPITOR) in the PROVE-IT study. Bristol-Myers sought to prove that its medication was better than the newer one, LIPITOR. They were wrong and it cost them.
The real challenge isn't just understanding what works better than others. The real challenge is how to get this information to doctors consistently and in a timely manner. Research shows that on average it takes 17 years for medical research and findings to be practiced routinely in the community doctor offices. Whether the internet and information technology shortens this time frame remains to be seen. As a result, all the studies in the world are meaningless unless those at the front lines - doctors and patients get this information.
I am skeptical that any study will ultimately help manage healthcare costs.