Evidence of Evidence-Based Policy: The Politics of Systematic Reviews in Coverage Decisions

Daniel M. Fox

Disclosures

Health Affairs. 2005;24(1):114-122. 

In This Article

Abstract and Introduction

Systematic reviews are contributing to the making of policy that conserves scarce U.S. resources.

U.S. policymakers are making greater use of findings from systematic reviews, the principal product of the discipline of research synthesis. This paper summarizes the methodology and availability of systematic reviews and the brief history of their introduction to policymakers in the public and private sectors and health professionals in the United States. Then, as a case study, the paper describes how officials in a consortium of states are using systematic reviews to inform decisions about coverage for pharmaceuticals. Finally, it explores the prospects for wider use of systematic reviews by policymakers.

Findings from systematic reviews, the principal product of the discipline of research synthesis, are being used increasingly by U.S. policymakers. Policymakers who use systematic reviews say that such reviews help them make decisions about allocating scarce resources and responding to advocacy for covering particular drugs, procedures, and medical devices. Most of this advocacy, by disease-specific groups, manufacturers, and organizations of providers, is based on the results of one or a few studies of primary data, often accompanied by anecdotes about particular interventions' effectiveness. In contrast, a systematic review arrays, evaluates, and summarizes the aggregate results of every study of an intervention (or of competing interventions) that can be found.

This paper summarizes the methodology and availability of systematic reviews and the brief history of their introduction to policymakers in the public and private sectors and health professionals in the United States. Then, as a case study, it describes how officials in a consortium of states are using systematic reviews to inform decisions about coverage for pharmaceuticals. Finally, it explores the prospects for wider use of systematic reviews by policymakers.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....