Outcomes Research: Issues of Evidence, Timing and Application

We have entered the era of value for money, and it will likely last into the next century. Increasingly, the use of pharmaceuticals will be a function of the value for money they bring to specific populations at risk. As an integral part of this era, the outcomes research movement is pursuing the quest for value; however, the movement is in its infancy. There is a great appetite for systematic outcomes research that would assess unmet clinical need, the novelty of the clinically meaningful outcomes, and the potential for monetary benefit. The basic premise of outcomes research is that choices between alternatives must be made to promote efficiency without compromising quality of care. Although choices must be made, the foundation for these decisions is properly good research evidence. The process of evidence generation is time-intensive, especially in diseases with long episodes of illness. Therefore, it will take time to produce clinically meaningful data on factors such as mortality and morbidity gains, health-related quality of life, productivity enhancements, patient and provider satisfaction and compliance, especially for new drugs. The needs are acute and the promise is great, but the movement is probably more evolutionary than revolutionary. Copyright © 1995 by W.B. Saunders Company