American Association for Cancer Research

AACR Cancer Policy Monitor - August 2012

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                                                                                                           August 2012

HOUSE PROPOSAL WOULD DEFUND PATIENT-CENTERED OUTCOMES RESEARCH

Measure would terminate agency responsible for research on quality of care

The Labor-Health and Human Services (HHS)-Education spending bill recently advanced from the House Appropriations Subcommittee includes a provision that would eliminate the Agency for Healthcare Research and Quality (AHRQ), the agency primarily responsible for funding research on the quality and effectiveness of health care delivery. AHRQ funds both primary research and evidence evaluation and dissemination, with the goal of translating scientific and technical advances into improved clinical practice. Roughly 80 percent of AHRQ’s budget, which was allocated $364 million in the Senate’s FY 2013 budget proposal, is typically spent in the form of grants and contracts to researchers across the country. 

While Chairman Rehberg (R-Mont.) stated that the move was simply a cost-saving suggestion by one of the subcommittee members, AHRQ is funded via an “evaluation tap” which siphons off a fraction of the NIH budget, so the elimination of the agency would not actually reduce overall spending, but would free up the equivalent amount in the NIH budget for other uses, effectively increasing the NIH budget. The elimination of the agency, therefore, may carry a specific policy message beyond budgetary savings, as it is accompanied by language that would forbid federal funding of patient-centered outcomes research, which would prevent the research typically sponsored by AHRQ from simply being shifted to other agencies, such as the NIH. 

This latter provision is part of a broader swipe at the Patient-centered Outcomes Research Institute (PCORI), the new, independent institute created by the Affordable Care Act to conduct comparative effectiveness research. While in fiscal year 2013 just over half of PCORI’s projected $320 million budget will be derived from revenues outside of the control of the appropriations committee, this proposed bill rescinds $150 million (47 percent of PCORI’s budget) in appropriated funds that do fall within the committee’s jurisdiction.

AHRQ sponsors the U.S. Preventive Services Task Force (USPSTF), which has been a recent target of lawmakers who have fought for reduced government involvement in health care. The USPSTF is not a government body, but rather is an independent expert advisory panel made up of non-governmental volunteers from medicine and academia. While the House spending proposal does not eliminate the USPSTF, it would transfer sponsorship of the USPSTF to the assistant secretary of health, a move that many see as threatening the group by exposing it to heightened political pressure. 

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