Issues

Evidence-based medicine can and should improve care for patients. 

Effective evidence based medicine:

• Recognizes that patients respond differently to medications and treatments

• Incorporates Patient-Reported Outcomes information, including Health Related Quality of Life

• Respects the patient/physician relationship

• Considers a broad range of data, including observational studies, claims data and practice guidelines developed by physician societies

• Considers individual patient preferences including racial, ethnic and cultural considerations, tolerance issues, medication interactions, etc.

• Allows the physician and patient, as a team, to decide which treatment is most likely to benefit the patient

• Recognizes that treatment strategies which cost more up front may actually lower overall treatment costs, such as disease management, care coordination and the integration of mental and physical health care

The American Medical Association has passed a groundbreaking resolution which rejects the concept of cost-based medicine in favor of patient-oriented evidence based medicine.  READ THE AMA RESOLUTION.

Ineffective evidence based medicine:

The Oregon Drug Effectiveness Review Project completes effectiveness and safety comparisons of drugs in a number of drug classes.  These reports, however, almost always conclude that the drugs in each class are essentially equal.

Numerous groups are using the Oregon Reports to justify the use of drug cost as the basis for choosing which medication a patient should use.

For example, Consumer’s Union has created a consumer program based upon the Oregon Reports, which recommends “best buy drugs” to consumers.  Best buy status is determined by the drugs’ costs.

Although managing the costs associated with medical care is very important, cost-based medical care should not be disguised as evidence-based medicine.

Read our Oregon response: ABM issue brief