Evidence based medicine - who could possibly be against that? The answer is that nobody is against basing treatment decisions on evidence. The question isn't who's for it, the question is what does "evidence-based medicine" mean. Everyone is concerned about the dramatically rising costs in health care. People who are directly affected--consumers, providers, government agencies and insurers--all have to take steps to address rising costs. However, many of the steps being taken by payers are simplistic shortcuts that use the concept of evidence based medicine to restrict access to the best and most effective care because "they" believe that newer treatments cost more and because "they" claim there isn't sufficient evidence to show that a newer treatment is better than an older and cheaper approach.

Who Should Join the Alliance:

Any patient advocate for people with chronic illnesses should be concerned because these are the people who are most likely going to need more extensive care. Treatment limitations based upon "evidence" do not only affect drug access, but they can potentially affect any aspect of care and treatment (tests, procedures, hospital care, etc.).

Anyone who represents an ethnic organization should care because a one size fits all approach invariably does not take into account racial, ethnic, age and sex differences and responses to treatments and medications as most "evidence" is based only on responses of male adult Caucasians.

Providers should be concerned because often the evidence only exists for an older practice that had been studied for decades. The newest and most promising practices that may cost more by themselves, but will have the effect of avoiding other interventions that would be even more costly, will not have sufficient evidence to justify them. Additionally, treatment limitations based upon "evidence" can potentially remove decision making authority from the hands of the physician.

Goal of the Alliance:

The goal of the Alliance for Better Medicine is not to oppose efforts to utilize evidence based medicine but it is to develop it in a manner that utilizes the best information and considers all of these factors in making decisions. What we are against is short-sighted shortcuts and simplistic solutions that come from people outside of the health care community and have not properly taken into account the views of those most directly affected by these impacts--the patients--particularly those who are facing chronic illnesses. If you are concerned about these issues you need to be a part of the Alliance for Better Medicine.

What will the Alliance for Better Medicine do?

Analysis: We will provide analysis in response to reports of government agencies and other interests that are touting these studies as a way to save money in healthcare costs whenever we believe that it really doesn't save money and it is simply looking at a very narrow approach that could lead to additional costs in other aspects of healthcare that are not accounted for.

Education: We will also hold symposia bringing together the best experts to advance evidence based medicine and utilize all the available claims data and other information that can be made available to insure that whatever decisions are made utilizing the best information and not a narrow selectively chosen bit of information that justifies a particularly narrow cost driven approach.

Public Policy: Most importantly we will strive to make sure that in all public policy decisions affecting available health care whether its under private plans or government funded program that decisions are made placing the interest of the patient first and looking at the best over all healthcare outcomes.

We are new and growing but we've already had an impact.

The Alliance for Better Medicine was formed in April of 2005 but already we have had the following impacts:

• Met with California Medi-Cal officials to affirm that they would not base their decisions solely on the Oregon Drug Effectiveness Review Project reports.
• We've also been monitoring California Public Employees' Retirement System (CalPERS) which has also provided funding to the Oregon study and confirmed that their formulary decisions will consider other information as well.
• We've held a symposium of leaders and published (and are publishing on the internet) the key findings. Attached is the executive summary of that event and the agenda that showed who the presenters were.

Time commitment required by members and supporting organizations:

The time commitment required by a supporting organization is minimal. We encourage all groups to keep the ABM informed of treatment access issues faced by your patients, and we will keep supporting organizations informed of our activities. No further participation in the Alliance is required, although participation in the monthly conference calls is encouraged.

Member organizations are encouraged to participate in monthly conference calls and required to send a representative to the annual meeting. Member organizations may be asked to assist the Alliance with media opportunities, legislative action alerts, identification of speaking opportunities, and opportunities for publication of articles. The amount of time committed to the Alliance will vary significantly between organizations, based upon the individual organization's available time and resources.

Help the Alliance for Better Medicine ensure quality evidence-based healthcare for all patients-join the Alliance today.