Declaring that “it’s high time that we built a foundation of evidence for the trillions of dollars spent on health in America each year,” US Democratic Senators Max Baucus and Kent Conrad have introduced legislation to create a Health Care Comparative Effectiveness Research Institute, which would “review evidence and produce new information on how diseases, disorders, and other health conditions can be treated to achieve the best clinical outcome for patients.”

The Congressional Budget Office (CBO) has estimated that the US could save up to $700 billion annually if physicians and patients had more unbiased data on the effectiveness of medical treatments available to them, according to Sens Baucus and Conrad who, respectively, chair the Senate Finance and Budget Committees.

The CBO, the Institute of Medicine and the Medicare Payment Advisory Commission have all urged Congress to “create a national entity charged with conducting research to determine what works in health care,” said the Senators, adding that their bill - the Comparative Effectiveness Research Act of 2008 (S 3408) - does “what the experts suggest.”

At present, of the $2 trillion spent by the USA on health in 2006, “only one-tenth of one percent was spent to assess what works and what doesn’t. At the Federal level, only $15 million was directly appropriated to compare the effectiveness of health interventions and services. People who purchase other goods - anything from cars to computers – use information to compare the value of the different products before they purchase. Physicians and patients deserve better,” said Sen Baucus.

Specifically, the Institute created by the bill would be a private-entity, nonprofit corporation responsible for setting national priorities for comparative effectiveness research. It would be governed by a public-private sector board of governors and would not be an agency of the federal government.

“Keeping it private would remove the potential for political influence on the development of national research priorities. Comparative effectiveness research will be more credible, and more useful, if it is done independently of political influence and with broad stakeholder input,” say the Senators.

The Institute would have authority to contract with federal agencies, or private researchers if appropriate, to conduct comparative effectiveness research studies, and be charged with disseminating their findings in ways that patients and providers can understand.

The bill includes stringent requirements for public input, transparency and integrity, say the sponsors; for example, the Institute would be required to publish its rules, proceedings and reports on a public Internet site and its meetings would be open to the public.

For its first three years, general revenues would be used to start the Institute up, with total funding for the first year of $5 million, increasing to $300 million a year by 2013. In the fourth year, funding would move to an all-payer system, from both public and private sources. All sources of funding would sunset after ten years.

The measure has been welcomed by insurance bodies such as the Blue Cross and Blue Shield Association (BCBSA), a federation of 39 companies which collectively provide health care coverage for more than one in three Americans, and by America’s Health Insurance Plans (AHIP), whose president, Karen Ignagni, said: “we believe this is the right time for this proposal and pledge to work with the Senators to advance comparative effectiveness legislation.”

A statement from the Pharmaceutical Research and Manufacturers of America (PhRMA) said the industry group supported the use of high-quality evidence for health care decision-making, but stressed that such evidence should “avoid denying or delaying patients’ access to beneficial care.”