Slide Presentation of the 2007 Annual Meeting of AHRQ

The Perils of EBM

• Potential for unintended consequences
  • Justifies coverage decisions based purely on cost without regard for overall effectiveness or value
  • Freezes the pace of innovation to the current generation of products
  • Discriminates against new technologies
  • Leads to prescriptive clinical protocols that do not allow for physician judgment and consideration of patient preferences
  • Focuses too narrowly on clinical morbidity or mortality, ignoring a range of other important patient-reported outcomes (ease of use, compliance, functional status)
  • Changes to coverage policies occur haphazardly without clear rationale, transparency or accountability