One of my favorite blogging colleagues (James Gault) writes

There is no doubt that comparative effectiveness research would be of great value to both patients and physicians if it could be done in an unbiased way uninfluenced by the special interests that seem to play such a role in much of the the government does,mission statements to the contrary notwithstanding. I hope it works out well but then I had that hope for Medicare.

Another writes (What will the stimulus bill mean to health care?)

Perhaps the more relevant question is whether such clinical research is best done by the government. The most notable example of government sponsored CER is ALLHAT. ALLHAT is also a notable example of agenda driven research, faulty design and inappropriate spin, every bit as much as you’ll find in pharma sponsored research.

I understand their concerns, but I cannot imagine a worse situation than we have now.  I will give one simple example that we discussed on rounds yesterday.  63 year old man is admitted with classic new onset angina. Because we are a VA facility, we do not have atorvastatin, rather we use simvastatin.  All the data on acute use of statins for CAD come from atorvastatin studies.  We assume that the beneficial effects on plaque stability are class effects, but we do not know.  I would love a comparative study of simvastatin (generic) and atorvastatin (still a trade drug.)

I see CER research as doing more of those studies than the ALLHAT type study.  If the money were going to CMS I would have greater worries than the money going to NIH and AHRQ.

I know many investigators who plan to apply for CER studies.  I hope they try to design unbiased studies.  I believe they will.