Researchers, patients sought to help advance comparative effectiveness research
One of the major research-related provisions of health care reform was the expansion of federally-funded comparative effectiveness research (CER), which aims to better understand and compare the clinical merits of different treatments, devices and procedures. The 2010 law set up a new, non-governmental organization called the Patient-Centered Outcomes Research Institute (PCORI), which has a charter through 2019 to fund CER. While the organization has taken time to get off the ground, recent activity by PCORI provides researchers, as well as patients, opportunities to shape the future of this important field of research.
Funding Opportunities: In August, PCORI announced a $26 million round of funding dedicated to developing a foundation for the future of patient-centered CER. The announcement seeks projects that will inform PCORI’s priorities, as well as projects that will develop CER methods and tools. A common theme that runs through most of the funding categories is enhanced integration of patient perspectives into CER and clinical decision making. A full listing of the categories can be found on the PCORI website, and letters of intent for this funding are due by November 1, with full submissions due by December 1.
Review Panel Opportunities: As with other grant-making organizations, PCORI will utilize scientific review panels to select projects for funding. As part of its mission to make the research patient focused, survivor or patient-advocate members will also be included on review panels. Interested patient representatives and scientists have until October 26 to apply to be a part of the review panels.
Staffing: Five senior-level director positions remain to be filled at PCORI. These positions, which will be critical to providing direction to the organization, are the directors of patient engagement, stakeholder engagement, finance, project management, and communication. More information regarding these openings and the application process can be found on the PCORI website, and the positions will remain posted until filled.
As PCORI establishes its infrastructure and operations, opportunities for further funding will continue to grow. PCORI will receive $50 million in federal funds in 2011 and $150 million per year from 2012 through 2019. Starting in FY2013 both Medicare and private health insurance plans will have to pay $2 per covered life into the PCORI trust fund. The combined appropriations and insurance fees are likely to provide PCORI with more than $500 million per year with which to fund CER. The creation of PCORI as an independent non-profit organization and the trust fund transfers will put the organization largely outside of the influence of the annual appropriations process and, in the eyes of advocates, protect it during the upcoming budget battles.
While CER in various forms has long been conducted by other agencies, including the Agency for Healthcare Research and Quality (AHRQ), the National Institutes of Health (NIH), the Department of Defense and the Veterans Health Administration, PCORI will be wholly focused on supporting this research and has also been tasked to make its work “patient-centered.” The organization is still in the process of defining what “patient-centered” means in the context of CER, but at its core, PCORI aims not only to involve patients in designing and conducting research, but also in making the outcomes of that research relevant to and understandable by patients. Toward this goal, all PCORI-sponsored research must be reviewed by a panel that includes patients and must gather and analyze patient-reported outcomes.
PCORI’s efforts will add to the ongoing CER activities at federal agencies, as well as the American Recovery and Reinvestment Act of 2009’s one-time investment of $1.1 billion in CER. An ongoing inventory of all federally-funded CER grants is maintained by the Partnership to Improve Patient Care (PIPC), and can be found at www.cerinventory.org.
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