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Comparative Effectiveness Research (CER)
SWHR has long advocated that a strong patient-centered comparative effectiveness research (CER) program can provide value to understanding biological and physiological sex differences affecting disease prevention, diagnosis, and treatment. A complex combination of biological, genetic, hormonal, physiological, and environmental factors influences health and disease in extraordinarily different ways in men and women.
Biological sex differences in disease and the response to therapeutics, some of which are present at birth and others that develop later, are pervasive and compelling. For example, diseases such as cancer, obesity, coronary heart disease, autoimmune disorders, and mental health disorders exhibit sex differences in susceptibility, prevalence, time of onset, and severity. In addition, we now know, but it is not yet widely understood in medical practices, that there are sex differences in common medications including antibiotics, antihistamines, antidepressants, antipsychotics, and some heart medications. Medical devices and procedures also show sex differences. For example, women have twice the risk of men for local complications after cardiac catheterizations. This could be due to blood vessel size or hormonal differences.
The research community is just now on the cusp of understanding that men and women are different in ways that go beyond their reproductive systems, hormones, and bone structure. Sex differences are also found in areas of disease prevalence and progression, presenting symptoms, and responses to treatment. To date, this knowledge has not been commonly adopted or understood by clinicians, which compromises the quality of health care that women receive.
SWHR recommends that sex differences be at the heart of comparative effectiveness research- evaluating and comparing the clinical effectiveness, risks, and benefits of two or more medical treatments, services, drugs, devices, biologics, care processes, and care management, while also taking into account differences based on patient’s sex, age, race, and ethnicity.
The research results must avoid creating unintended access barriers, coverage denials, or arbitrary dollar thresholds that can arise through centralized cost-effectiveness determinations. By focusing on gaps in clinical knowledge, the research findings can improve the quality, and ultimately, the value of health care.
To view the most up-to-date CER news, please visit the main policy page.
To view SWHR letters concerning comparative effectiveness research please click on the links below:
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