Statement: PCORI Executive Director Joe Selby on the Center for American Progress's New Analysis of the Patient-Centered Outcomes Research Institute

PCORI Executive Director Joe Selby, MD, MPH, issued the following statement about today's release of the Center for American Progress's new analysis of the Patient-Centered Outcomes Research Institute.

We appreciate the Center for American Progress’s (CAP’s) interest in and analysis of our work, and its ongoing support of our mission to fund comparative clinical effectiveness research (CER) that will help patients and those who care for them make better-informed healthcare decisions.

Our work to date, and the promise of the body of research we are building with input from patients and others across the healthcare community, has provided the country with a powerful CER infrastructure that can make health research more relevant and useful as well as improve care and outcomes. My recent PCORI blog post provides a more-detailed review of our work and its impact.

PCORI’s work is essential because poor health outcomes along with inappropriate and wasteful care are commonplace in our country, across the entire spectrum of care, despite the tremendous advances we’ve seen from our investments in health research, prevention, and care. What’s missing is the evidence that can come from comparative effectiveness research conducted with a focus on the information needs of patients, clinicians, and other decision makers. This kind of research evidence can be used to help make more-informed decisions about care and policy.

Engaging patients and other stakeholders throughout the research process is key to closing this gap; PCORI is changing the very culture of research by requiring and promoting this approach. We see increasing examples of how, beyond the studies we fund, PCORI is influencing the research community broadly to be more patient-centered. All of us will benefit as a result.

Although we disagree with a number of CAP’s assumptions and analyses, we agree that a greater focus on CER can “arm health care consumers, providers, and payers with a greater understanding of how effective treatments truly are,” which can improve the quality and value of care and, eventually, health and patient outcomes. We appreciate CAP’s recognition of our growing investments in CER projects focused on high-burden conditions, including many studies focused directly on drugs.

CAP notes an increase in our support for studies of drugs in the past year. This is not the result of a simple decision by PCORI leadership to allocate more funding to such studies; it shows that our process of involving stakeholders in prioritizing topics for funding works. As more new treatments have appeared in the past two years, our prioritization process has recognized important CER questions related to them. We expect this trend to accelerate further in coming years, but it will depend on the needs perceived by the full range of stakeholders.

We also find a number of CAP’s recommendations helpful and in line either with what we already are pursuing or plan to pursue. This includes using PCORnet, the large clinical data network developed with PCORI support, as a platform for critical studies, including of drugs; investing more in CER studies that can address evidence gaps in high-burden areas such as oncology, multiple sclerosis, and other conditions; and investing in systematic reviews synthesizing existing CER studies. These suggestions certainly fit well within our broader mission to fund a wide range of patient-centered CER studies prioritized by stakeholders, as well as to advance CER methods and infrastructure.

We know that we ultimately will be judged by whether the research we fund can change practice; inform patients, their clinicians, payers, policy makers and others; and help reduce the variations and disparities that stand between patients and better health outcomes. We’re confident that the patient-centered processes we’ve built and the research portfolio they have produced will show that we have invested the public’s money wisely to do just that.