What PCORI Wants

Kathryn A. Phillips PhDProfessor of Health Economics &

Health Services ResearchDept Clinical Pharmacy/IHPS/Cancer

Center, UCSF

The Center for Translational and Policy Research on Personalized Medicine

Goo-Goos & Pinky-Ringers?

Today’s Conversation

• What is PCORI funding and why

• What are challenges & opportunities now and in the future

Winner #1: David Thom

• Health Coaches: Health Team Support for Patient Informed Decision Making

• Why Successful?

– Joined academic research w/ stakeholder involvement

• Questions & Challenges?

– How to create meaningful collaboration w/ stakeholders who are not familiar with research process?

– How will collaboration change research process, results, & dissemination/application of research?

Winner #2: Diane Allen

• Disability & Rehabilitation: Mind the Gap—Targeting Differences in Patients’ Current and Preferred Abilities

• Why Successful?

– Focused on patient-reported outcomes, when relevant to patient

• Questions & Challenges?

– What is this institute and what influence will it have in health care research moving forward?

Awards

National Pharmaceutical Council <info@npcnow.org>

And What Did NOT Get Funded

• Objective is to advance observational data approaches for reflecting patient variabilityand subpopulations

– YES: Engaging stakeholders in how to best use health plan data; topics of interest

– NO: Use of health plan data not innovative enough; methods not sufficiently detailed; (health plans not a focus of PCORI)

Others Not Funded

• #1: Problem not important enough –population too small

• May not change practice – little room for patient preferences to change decisions

• #2: A study of how to improve policy decisions did not include patients as stakeholders (now policymakers considered stakeholders?)

• Methods insufficient

What Does PCORI Want?

• Expect to commit $355 million in 2013

• Funding

–Pilots (awarded)

– Five priority areas

– Topic specific areas (early 2013)

–Contracts

– “Challenge”

• Cash awards for prototype of patient/researcher matching system

1. Prevention, dx, tx2. Healthcare systems3. Communication & dissemination4. Disparities5. Methods

AHRQ Grants (2013)

• Patient-Generated Health Outcomes Data and Clinical Decision Support Using Smart Device Technology

• Enhancing Comparative Effectiveness Research (CER) Data Resources • Institutional Mentored Career Development Award Program in PCOR.• Researcher Training and Workforce Development in Methods and

Standards for Conducting Patient-Centered Health Outcomes Research Studies

• Individual Mentored Career Development Award Program in PCOR • Electronic Data Methods (EDM) Forum: Phase II• Bringing Evidence to Stakeholders for Translation (BEST) to Primary

Care• Disseminating Patient Centered Outcomes Research to Improve

Healthcare Delivery Systems• Deliberative Approaches for Patient Involvement in Implementing

Evidence-Based Health Care•

Methodology RFA

• Patient‐centeredness

• Systematic reviews

• Inclusion of stakeholders: topics, peer-review

• Methods for CER

• Data sources

• Reproducibility

• Training in PCOR methods

Challenges & Opportunities

• Real world evidence

• Incorporating stakeholder perspectives

• Focus on patient heterogeneity

• Prohibited from using “cost per QALY as threshold”

• Evolving landscape

• Speed up review process?

• Stakeholder burnout

• Fiscal situation

Understand the Culture

• Goo- goos – good government – CER needed to ensure value

• Pinky-ringers – political realists –“where’s mine?”

• PCORI is compromise – independent, non-profit, no yearly Congressional appropriation (until 2019)

–No longer “CER” and no mention of costs

There’s a wonderful rule of thumb

for American health care:

Shift happens

Uwe Reinhardt