Comparative Effectiveness Research and Evidence-Based Health Policy

Experience from Four Countries

Kalipso Chalkidou, Sean Tunis, Ruth Lopert, Lise Rochaix, Peter T. Sawicki, Mona Nasser, Bertrand Xerri

Research output: Contribution to journalArticle

Abstract

Context: The discussion about improving the efficiency, quality, and long-term sustainability of the U.S. health care system is increasingly focusing on the need to provide better evidence for decision making through comparative effectiveness research (CER). In recent years, several other countries have established agencies to evaluate health technologies and broader management strategies to inform health care policy decisions. This article reviews experiences from Britain, France, Australia, and Germany. Methods: This article draws on the experience of senior technical and administrative staff in setting up and running the CER entities studied. Besides reviewing the agencies' websites, legal framework documents, and informal interviews with key stakeholders, this analysis was informed by a workshop bringing together U.S. and international experts. Findings: This article builds a matrix of features identified from the international models studied that offer insights into near-term decisions about the location, design, and function of a U.S.-based CER entity. While each country has developed a CER capacity unique to its health system, elements such as the inclusiveness of relevant stakeholders, transparency in operation, independence of the central government and other interests, and adaptability to a changing environment are prerequisites for these entities' successful operation. Conclusions: While the CER entities evolved separately and have different responsibilities, they have adopted a set of core structural, technical, and procedural principles, including mechanisms for engaging with stakeholders, governance and oversight arrangements, and explicit methodologies for analyzing evidence, to ensure a high-quality product that is relevant to their system.

Original languageEnglish (US)
Pages (from-to)339-367
Number of pages29
JournalMilbank Quarterly
Volume87
Issue number2
DOIs
StatePublished - Jun 2009
Externally publishedYes

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Comparative Effectiveness Research
Health Policy
Delivery of Health Care
Biomedical Technology
Developed Countries
France
Germany
Decision Making
Interviews
Education
Health

Keywords

  • Comparative effectiveness research
  • Health reform

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health Policy

Cite this

Chalkidou, K., Tunis, S., Lopert, R., Rochaix, L., Sawicki, P. T., Nasser, M., & Xerri, B. (2009). Comparative Effectiveness Research and Evidence-Based Health Policy: Experience from Four Countries. Milbank Quarterly, 87(2), 339-367. https://doi.org/10.1111/j.1468-0009.2009.00560.x

Comparative Effectiveness Research and Evidence-Based Health Policy : Experience from Four Countries. / Chalkidou, Kalipso; Tunis, Sean; Lopert, Ruth; Rochaix, Lise; Sawicki, Peter T.; Nasser, Mona; Xerri, Bertrand.

In: Milbank Quarterly, Vol. 87, No. 2, 06.2009, p. 339-367.

Research output: Contribution to journalArticle

Chalkidou, K, Tunis, S, Lopert, R, Rochaix, L, Sawicki, PT, Nasser, M & Xerri, B 2009, 'Comparative Effectiveness Research and Evidence-Based Health Policy: Experience from Four Countries', Milbank Quarterly, vol. 87, no. 2, pp. 339-367. https://doi.org/10.1111/j.1468-0009.2009.00560.x
Chalkidou, Kalipso ; Tunis, Sean ; Lopert, Ruth ; Rochaix, Lise ; Sawicki, Peter T. ; Nasser, Mona ; Xerri, Bertrand. / Comparative Effectiveness Research and Evidence-Based Health Policy : Experience from Four Countries. In: Milbank Quarterly. 2009 ; Vol. 87, No. 2. pp. 339-367.
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