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Deloitte Comparative Effectiveness Study Evaluates Potential Savings Opportunities for U.S. Health Care System

ATLANTA, May 19 /PRNewswire/ -- A new Deloitte study profiling the comparative effectiveness systems of the United Kingdom, Australia, Canada and Germany was released today at the 2009 BIO International Convention in Atlanta. The findings of the report, available at, conclude that if implemented correctly, comparative effectiveness has the potential to improve care and reduce health care costs for Americans.

Deloitte examined three clinical examples of comparative effectiveness studies across the four countries' national programs. The three examples are diagnostic screening detection (colon cancer), a medication (the use of statins for treatment of elevated cholesterol) and a surgical procedure (treatment for benign prostatic hyperplasia).

"The results of our study demonstrate that, while the lessons from the other countries' approaches to comparative effectiveness are instructive, a cut-and-paste approach will not work in the United States," said Paul H. Keckley, Ph.D., executive director, Deloitte Center for Health Solutions. "Comparative effectiveness can be seen as an engine for renewed innovation in the design and delivery of evidence-based care. Health care information technology (HIT), such as electronic health records, may also play a critical supporting role in its evolution."

The study, conducted by the Deloitte Center for Health Solutions, illustrates the complexity and usefulness of comparative effectiveness to identify the benefits and limitations that can help the U.S. health care system learn from the other systems as health care reform and comparative effectiveness programs are further developed and funded in the United States.

Findings from the report conclude:

  • Although the current annual health care investment in the United States is $2 trillion, less than 1 percent is invested in assessing the comparative effectiveness of available interventions.
  • The American Recovery and Reconstruction Act (AARA) of 2009 allocated $1.1 billion to comparative effectiveness research. Although this represents a major increase in resources for this research, the cost of building national programmatic capacity and establishing a comparative effectiveness framework; support for trials, syntheses and analytics; and the development of dissemination and education strategies will challenge this initial investment.
  • National governments in Britain, Canada, Germany, Australia, France and the Netherlands have responded with unique strategies to deal with evidence development in clinical and comparative effectiveness.
  • Britain and Australia have designed programs that are directly linked to decisions that determine national health benefits. Germany and Canada use the outcomes of their programs in an advisory capacity for national health benefit decisions.
  • Building capacity to expand study, monitoring and clinical application of the relative effectiveness of health care interventions is a major challenge in reforming the U.S. health care system.
  • Research and development (R&D) processes in life science organizations will necessarily adapt to the realities of comparative effectiveness. Leaders will necessarily become more risk averse as comparative effectiveness becomes a standard for coverage.
  • Transparency in clinical R&D will likely follow the implementation of comparative effectiveness. The visibility of processes for determining efficacy and effectiveness will be visible to all stakeholders, and side-by-side comparisons will be a basis for active discussion among stakeholders.

"As the life sciences industry braces for health care reform, comparative effectiveness has the potential to fundamentally change the industry," said Terry Hisey, vice chairman and U.S. Life Sciences industry leader, Deloitte LLP. "Our report examines how comparative effectiveness programs leverage both medicine and clinical decisions to achieve varying results across different patient populations. For comparative effectiveness to work in the United States, it will require cooperation between all stakeholders, from life sciences companies to payers, providers, policymakers and consumers, to achieve maximum benefits."


Consumers, as the primary recipients of the product of the health care system, have an incredible stake in the effectiveness and efficiencies of health care services. Yet, data from the Deloitte 2009 Survey of U.S. Health Care Consumers indicates that only 27 percent of consumers report that they understand how the health system works, with 16 percent reporting that they have no understanding or very slight understanding. These findings underscore the significance of the potential gap regarding comparative effectiveness research findings and what consumers feel they know about how the health system works and how they view health system performance.

As comparative effectiveness programs are developed in the United States, life sciences companies may find the following information from the Deloitte 2009 Survey of Health Care Consumers valuable about the attitudes and behaviors of health care consumers:

  • Only 11 percent of consumers view pharmaceutical, biotech or medical device/product manufacturers as trusted sources of health information.
  • Only 27 percent of consumers view the food and drug administration (FDA) as a trusted source of health information.
  • More than half (52 percent) of prescription medication users take three or more medications; 24 percent take five or more.
  • Thirty-five percent of those who report not filling a prescription did so because of cost concerns.
  • Three in 10 say they switched medications in the last 12 months; 38 percent of these switched to save money.
  • Eight in 10 say they would consider switching from a physician- recommended medication if a pharmacist indicated that a cheaper alternative was available.
  • Six in 10 prefer generic drugs over branded drugs to save money, unless they believe a specific brand is more effective.
  • Familiarity with "biologics" (defined as a class of drugs that uses human cells to create the drug instead of chemicals) is low -- 12 percent say they understand the term.
  • Seven in 10 estimate that a genetic test to help identify a chronic problem would cost $100 or less; estimates of costs for genetic tests ranged from less than $100 to $5,000.
  • One in six say they would choose an experimental drug for a serious but not life-threatening problem, even if it hasn't been widely tested.
  • One in five consumers prefer alternatives to traditional medicine, including homeopathic, chiropractic and naturopathic approaches and therapies.
  • Sixty-eight percent are interested in home/remote monitoring devices that enable self-monitoring of their condition and electronic reporting of results to their physician; seniors (78 percent) and consumers with a chronic condition (75 percent) express highest interest.

Related Content

Report: Comparative Effectiveness (

Report: 2009 Survey for Health Care Consumers (

Overview: Deloitte Center for Health Solutions (

Profile: Paul Keckley, Ph.D (

Profile: Terry Hisey (

About Deloitte

As used in this document, "Deloitte" means Deloitte LLP and Deloitte Services LP, a subsidiary of Deloitte LLP. Please see for a detailed description of the legal structure of Deloitte LLP and its subsidiaries.


    Marykate Reese                      Sean Leous
    Public Relations                    Public Relations
    Deloitte                            Hill & Knowlton
    +1 203 257 0452                     +1 917 715 3765      

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