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Republicans Raise Issue of Rationing and NICE at Markup

June 20, 2009 (LPAC)—The Senate Health, Education, Labor and Pensions Committee spent most of its markup session Friday morning debating an amendments by Sen. Pat Roberts (R-Kan.) to prohibit any agency of the Federal government, but most especially the Center for Medicare and Medicaid Services (CMS), from using comparative effectiveness research (CER) to make treatment, coverage, or payment decisions. Roberts noted that the CMS already has a long track record of using such data to deny treatments, and that the Obama Administration has already made clear that it intends to use CER to cut costs. Sen. Tom Coburn (R-Okla.) told the committee that what they're actually talking about, is rationing care. "CMS will use this information to limit the use of advanced technologies that could save lives, because it'll save money," he said.

Sen. Mike Enzi (R-Wyo.), the ranking Republican on the committee, noted that what the Republicans are concerned about, is "what goes on in Europe, where they block breast cancer patients from receiving breakthrough drugs, where they force patients to wait extra years for treatment, where Alzheimer's patients are kept from receiving early treatment.... I'm worried about this information being used the same way in this country."

Roberts' amendment was defeated on a voice vote, but Enzi made clear that the debate is far from over, since the Republicans have 15 more amendments dealing with comparative effectiveness, including one by Enzi on use of Quality Adjusted Life Year information to make treatment decisions.


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