Health Affairs

Health Affairs, doi: 10.1377/hlthaff.25.w279 (Published online June 6, 2006) © 2006 by Project HOPE	New Online   Getting Health Reform Done   After the State of the Union   Incremental Reform   E-Health in Developing World   Most-Read Articles in 2009

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Evidence-Based Coverage Decisions? Primum Non Nocere

Newell E. McElwee ^1*, S. Yin Ho ², Kimberly A. McGuigan ³, Mark L. Horn ⁴

¹ The authors are all with Pfizer Inc. in New York City. Newell McElwee is vice president of U.S. outcomes research in the U.S. Medical Group.
² S. Yin Ho is senior director of health strategy in the U.S. Planning and Business Development Group.
³ Kimberly McGuigan is director/team leader of the Evidence-based Medicine Center of Excellence, U.S. Outcomes Research, in the U.S. Medical Group.
⁴ Mark Horn is medical director of the Government Relations Group.

^*Corresponding author.

Abstract

Drug class reviews are blunt tools for medical decision making. The practice of evidence-based medicine is far more than simply systematic reviews: The patient and doctor are integral. Here we highlight areas of evidence-based coverage decision making where greater balance and transparency could serve to improve the current process, and we recommend elements of a more positive approach that could optimize patient outcomes under resource constraints. [Health Affairs 25 (2006): w279-w282 (published online 6 June 2006; 10.1377/hlthaff.25.w279)]

Key Words: Access To Care, Consumer Issues, Health Reform, Insurance Coverage, Managed Care - Medicaid, Medicaid, Pharmaceuticals, State/Local Issues, Evidence-Based Medicine

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