I wrote in August about the problems and costs associated with drugs and procedures that either don't work at all or don't work as well as simpler or cheaper alternatives. Not only does the widespread use of such treatments render medical care of poorer quality than would otherwise be the case, it also costs as much as $700 billion out of the $2.3 trillion the U.S. spends annually on health care.
The good news is, there's a wealth of research in this area on which to base treatment and policy changes. The bad news, according to this New York Times story that ran on -- yeesh -- Thanksgiving, is that all that research does no good at all if physicians don't use the findings.
The article cites a study that found that in treating high blood pressure, generic diuretics, which sell about as cheaply as prescription drugs can sell, outperform calcium channel blockers, alpha blockers and ACE inhibitors that can cost 50 times what the diuretics cost. That study, which looked at 42,000 patients and cost $130 million, was led in part by Dr. Curt Furberg of Wake Forest, whom I quoted in my August article.
The article goes on to explain why these findings don't result in changes in the way the U.S. practices medicine. And the case illustrates that whatever else happens with health-care reform in this country, we must find a way not only to routinely assess relative and absolute effectiveness of treatments but also to see that best practices become the practices that are actually used. Many lives and a lot of money hang in the balance.
