I Believe in Non‐​Political Government Comparative‐​Effectiveness Research (and in the Tooth Fairy, Santa Claus…)

My colleague Michael Cannon has been writing about the folly of government-sponsored comparative effectiveness research. Now, in an article in the Journal of the American Medical Association (subscription required), John Kraemer and Lawrence Gostin add another cautionary note for those who believe that the government’s decisions will be based on science and not on politics. In particular, the authors discussed how the Connecticut Attorney General has attacked the Infectious Disease Society of America (IDSA) for recommending against the use of long-term antibiotics to treat “Chronic Lyme Disease.” Although the IDSA based its non-binding recommendation on the overwhelming scientific evidence, the International Lyme and Associated Diseases Society (ILADS), a well connected and media-savvy advocacy group for those with Lyme disease protested, taking its case to the Connecticut political establishment. As a result, Connecticut Attorney General, Richard Blumenthal sued the IDSA under the state’s anti-trust laws.

Political institutions are by definition political. A government body deciding on the comparative-effectiveness or cost-effectiveness of medical treatments will inevitably base its decisions as much on politics as on science.