Articles/Links: Evidence-Based Reviews of Drugs

• The Drug Effectiveness Review Project: An Important Step Forward Authors: M. Gibson and J. Santa - June 6, 2006
  Publication: Health Affairs
  This article, written by John Santa, Medical Director of the Drug Effectiveness Review Project (DERP) and Mark Gibson, the Deputy Director of the Center for Evidence-Based Policy at the Oregon Health and Science University, serves as an introduction to the important work of the project. It is also a strong rebuttal to Peter Neumann's article (Emerging Lessons from the Drug Effectiveness Review Project, as well as other DERP critics. "At its core", the authors contend, "the debate over the DERP centers on the differences between an approach that relies on physicians and patients attempting to unravel mounds of marketing data selected specifically to increase market share of individual drugs versus one in which physicians, consumers, and policy makers alike have access to a systematic assessment of effectiveness and safety of the drugs in question, based on the best quality evidence available."
• Emerging Lessons From The Drug Effectiveness Review Project Author: P. J. Neumann - June 6, 2006
  Publication: Health Affairs
  The author (at Tufts University School of Medicine) discusses the DERP experience from its creation and governance, to its process for reviewing evidence and then raises important questions about the project from the pharmaceutical industry, drug company supported patient advocacy groups and some professional medical societies. Criticisms revolve around issues of therapeutic class effects, DERP's reliance on randomized control trials (RCTs) to the exclusion of observational studies and other data sources, open participation in the review by organizations raising the questions, transparency of the process, cost-effectiveness information, and the role of government in judging evidence.
• The DERP: Is It An Effective Methodology? Author: A. Heaton - June 6, 2006
  Publication: Health Affairs
  The author, the director of Pharmacy for Blue Cross and Blue Shield of Minnesota, provides an important perspective on Peter Neumann's article (Emerging Lessons from the Drug Effectiveness Review Project). The article deals with several external factors impacting the DERP including the lack of sufficient evidence-based medical data for new drugs, the reliability of the evidence, and the role local state politics. While showing the inherent limitation of the DERP process, the author defends the use of evidence-based formularies, the staged used of drug therapies, and the need to get the DERP information into the hands of medical professionals and consumers as soon as possible.
• Bringing The DERP To Consumers: 'Consumer Reports Best Buy Drugs' Author: Steven D. Findlay - June 6, 2006
  Publication: Health Affairs
  The author, the managing editor of Consumer Report's Best Buy Drugs (CRBBD) at Consumers Union, describes CRBBD "which translates the DERP's findings for consumers and combines that with drug price and cost data, to produce an independent and unbiased resource on the comparative effectiveness and value of prescription drugs." The author emphasizes the importance of CRBBD as an informational tool for patients in speaking with their doctor about their prescription drug needs.
• Evidence-Based Coverage Decisions? Primum Non Nocere Authors: N. E. McElwee, S. Yin Ho, K.A. McGuigan and M. L. Horn - June 6, 2006
  Publication: Health Affairs
  In an additional perspective on Peter Neumann's article, Emerging Lessons From The Drug Effectiveness Review Project, the authors (all employees of Pfizer Inc.) address Neumann's critique around issues of program intent, methodological issues, transparency and stakeholder involvement. The authors then focus on an additional issue concerning the use of systematic reviews in averaging data and the degree of its applicability to the individual patient.
• Evidence of Health Policy: The Politics Of Systematic Reviews In Coverage Decisions Author: D.M. Fox - January 1, 2005
  Publication: Health Affairs
  This article serves as an excellent starting point for understanding systematic review, as a key product of the discipline of research synthesis, as well as an introduction to evidence-based health care. The author then uses the Drug Effectiveness Review Project (DERP) as a case study and examines the wider implications of systematic reviews for policy makers.