1. Bringing Evidence-Based Medicine to Consumers Alliance for Health Reform January 12, 2005 Gail Shearer Director, Health Policy Analysis Washington Office Consumers Union

2. “Consumer Driven” Health Care? Is it defined contribution health care in reality? Adverse segmentation of the health insurance marketplace Evidence-based medicine should be foundation for universal coverage, comprehensive drug benefits, and improvements in the marketplace as it saves money and rationalizes delivery of care

3. Section 1013: Medicare Modernization Act Bipartisan effort Appeals to those who want to provide financial relief Appeals to those who want to curb federal spending and deficit AHRQ priorities: constructive first step Section 1013 calls for findings that are “easily understood” by the public and available both online and in print

4. MISSION: Information on prescription drugs for consumers and doctors Increase access to and affordability of needed medicines Relieve financial burden caused by high drug prices – consumers and businesses

5. METHODS: (1) Drug Effectiveness Review Project Pioneering work under leadership of former Oregon Governor John Kitzhaber Partnership (DERP) now includes 12 states and two non-profit organizations Systematic reviews by AHRQ’s Evidence-Based Practice Centers Process: transparent, unbiased, rigorous, highly regarded

6. METHODS: (2) Medical Input and Prices Input from medical consultant Data on average national retail price paid by cash-paying consumer CU team reviews effectiveness and cost Input from CU’s medical advisor, health editorial team, statistician, 2-3 outside medical peer reviewers for each category

7. METHODS: (3) Identifying CR Best Buy Drugs CU team reviews the effectiveness and cost data, and selects one or more drugs that: Are in the top tier of effectiveness Have a safety record as good as others in the category Have an average price substantially lower than the most costly drug in the category

8. CR BEST BUY DRUGS: Cholesterol–Lowering Drugs/Statins For moderate cholesterol reduction: Generic lovastatin Substantial cholesterol reduction: Atorvastatin (Lipitor)

9. POSSIBLE ANNUAL SAVINGS: 3 Categories Statins $1,300 (cholesterol) Proton Pump Inhibitors: $1,740 (acid reflux and ulcers) NSAIDs $2,200 (arthritis and pain)

10. Just the beginning … Continue to draw on DERP reports One per month Next up: anti-depressants (SSRIs), high blood pressure and heart disease (ACE Inhibitors and Beta Blockers)