Health Panels Are Nothing To Fear

August 24, 2009|By Adran Baker

One of the proposals for health care reform is to have a panel of medical experts oversee Medicare in order to improve quality and reduce cost. But false accusations permeating the debate have scared people into thinking that would mean a government bureaucrat deciding what treatments you should or shouldn't have, and would ultimately deny your grandma her vital drugs.

Like any debate involving the future, fear of the unknown is going to be used by those who want to maintain the status quo for their own self interest. But health panels are not unknown. They have been used in Britain for 10 years, and have been proven to work.

Health panels are a simple enough idea: Experts look at the evidence out there and make sure it's the best that is available. They then make recommendations based on analyzing hundreds of studies and consulting numerous stakeholders. The recommendations suggest the best form of treatment and care for a particular condition, or provide advice on areas about which your doctor may be unsure.

The recommendations aren't mandatory, the government isn't involved, and there is no tying of hands. The decision to follow these recommendations will always be with your doctor because he or she knows you best. All that happens is that your doctor can make a better, more informed decision and will no longer have to choose between spending time treating you or spending time reading up on the latest evidence.

The National Institute of Clinical Excellence (NICE) - the health panel in Britain - has been improving the quality of medical care in a health system that oversees a population with a higher life expectancy than in the U.S. at a fraction of the cost. This is because NICE has followed through its two main goals: to improve clinical effectiveness and to improve cost effectiveness.

And these are laudable goals that lead to better medical treatment, better patient safety and a reduction in wasteful spending. NICE also helps to reduce the amount of unnecessary spending on treatment that hasn't proved to make any difference to a patient's well being and quality of life.

Pharmaceutical companies are, therefore, pressured to demonstrate that drugs are effective and worthwhile in order for them to be recommended. NICE makes these cost-effectiveness decisions based on clinical evidence. For example, there is no evidence that brand-name paracetamol is better than the generic version. Yet the brand-name version can sometimes have over a 100 percent mark-up on the generic version. In this situation, NICE would recommend the use of the generic version of paracetamol. Not only is this better for the patient but it also reduces cost and frivolous use of money that could be spent on better treatments or more doctors.

Within its first 10 years, NICE guidance has led to more cancer specialists, better use of drugs, better treatment and far greater cost-effectiveness. As a result, Britain has been experiencing an ever-increasing quality of care. So learn from the NICE example and discuss health panels on their merits, not based on false accusations. Our health panel is made up of experts completely independent from the government, independent from drug companies and independent from insurance companies.

Our health panel gives doctors evidence-based guidelines on what treatment works best for patients, saving a lot of time - and sometimes pain - for people who go through countless tests or procedures that aren't needed. And our health panel makes sure health care is cost-effective by providing incentives for pharmaceutical companies to lower their price and prove a drug actually works if they want it to be recommended. NICE has shown that both economically and clinically, health panels make sense.

Adrian Baker is a researcher for Britain's National Health Service in London. His e-mail is

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