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Comparative Effectiveness Research in the United States: Update and implications

New issue brief examines CER in the context of health care reform


One of the challenges confronting the U.S. health care system is delivering high-value, effective therapies that provide the best health outcomes. Comparative Effectiveness Research (CER) has been proposed as a way to align diagnostics and treatments with evidence and to understand the real-world, incremental value of health technologies in differing patient populations.

Enactment of The American Recovery and Reinvestment Act (ARRA) and the Affordable Care Act (ACA) reignited the federal government's interest in CER. The newly mandated Patient-Centered Outcomes Research Institute (PCORI) is responsible for sponsoring scientifically rigorous CER studies, and for assisting patients, clinicians, payers, and policy makers in making informed health care decisions by advancing the quality and relevance of evidence.

In 2009, the Deloitte Center for Health Solutions published an Issue Brief that examined the history of CER in the U.S. and reviewed examples of four national CER programs. This new Issue Brief:

  • Revisits CER following the enactment of the ACA
  • Describes the ACA's legislative mandate for CER
  • Offers suggestions for U.S. policy makers based on lessons learned from international CER experiences
  • Shares implications for U.S. stakeholders
  • Explores enablers that might facilitate CER's use as “tools, not rules” in transforming the U.S. health care system.

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