( More lives could be saved in the United...)Access to existing medical treatments could save more lives than spending to improve the treatments

More lives could be saved in the United States by spending less money on making medical treatments better and more on getting existing treatments to the patients who need them, according to a study published by a Virginia Commonwealth University family medicine and public health physician.

"For every dollar Congress gives the National Institutes of Health to develop blockbuster treatments, it spends only one penny to ensure that Americans actually receive them," said Steven H. Woolf, M.D., professor and director of research in VCU's Department of Family Medicine and a member of the National Academy of Sciences' Institute of Medicine. "This reflects, in part, a misperception that the improved drugs, procedures and the like will improve health outcomes, and that does happen. But the health improvement would be far greater if we worried less about making incremental improvements on existing treatments and more on the system barriers that impede Americans from receiving those treatments correctly." The study was coauthored by Robert E. Johnson, Ph.D., an associate professor in VCU's Department of Biostatistics.

Woolf and Johnson, whose study appears in the Dec. 6 issue of the Annals of Family Medicine, said a mathematical construct proves the point. They used two case studies -- one involving statins and the other antiplatelet drugs -- to show that the billions of dollars spent on new generation drugs saved fewer lives and prevented fewer strokes than if the existing drugs had been taken by all patients who could benefit. They cited reports that Americans receive only half of recommended health care services and that disparities in care are worse for minorities and disenfranchised patients.

The study poses a contrast between efficacy, or how well a treatment works, and what they call the "fidelity of health care." Independent of the efficacy, fidelity is the extent to which the health care system provides patients the precise interventions they ne
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Source:Virginia Commonwealth University

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