Cleveland Clinic’s Cosgrove on Health Care Reform and Innovation

Cleveland Clinic Chief Executive Toby Cosgrove “told a full house at a City Club speech that he’s concerned that health-care reform could stifle medical innovation.” Specifically, he told more than 250 participants in response to a question that the effects of health-care reform are causing him to “worry very significantly about innovation.”

In particular, Cosgrove was pointing to the part of the health care law that funds comparative-effectiveness, which he asserted “is shorthand for studying different treatments and paying for those that work.” His concern about comparative-effectiveness is that it will create a system where “we only pay for one of those, and we begin to limit what people are willing to do in terms of developing new products.”

To demonstrate his concern, he gave the example of how “right now, a new heart valve takes 10 years to go from concept to clinical. And it takes 10 years more to know if it’s better than the next heart valve.” Using those numbers, he asked whether an investor or a manufacturer would be interested in essentially putting their dollars down not knowing whether they’re going to get a return on those dollars for 20 years. And for most investors, “that’s a stretch.”

As a result, he recognized the need for consumers and the public to watch how the regulations are written and implemented, and to keep an eye on how health care reform effects our exports, our employment, and one of our major industries in the United States: medical devices and drugs.

While Cosgrove is still concerned about the effects this legislation will have, some feel that Congress “and others are listening to the medical industry’s worries” already. For example,  Tom Hubbard, senior program director for the New England Healthcare Institute, noted that even the Institute of Medicine recognizes the need to protect innovation,” and that “in general, nobody is against developing the next life-saving drug or the next life-saving device.”

Others, such as David E. Williams, a health-care business consultant and principal at MedPharma Partners in Boston, don’t “see comparative effectiveness slowing innovation either.” In fact, Williams sees comparative effectiveness “making it more likely that things that are truly innovative and will make it to market and it will discourage things that are flashy and expensive but don’t add much clinical value.”

Despite their optimism, Cosgrove recognized in his speech that organizations and institutions must continue to be creative and to drive innovation. As a result, his comments correctly pointed out that in order to “ensure our future success as a vibrant and growing international health-care delivery system, we must continue to put our patients first.”

Accordingly, to carry out this mission, health care reform must not hinder health care providers and entities from taking risks with ideas, and collaborating with industry, government and academia to achieve the best results possible for patients.

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