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QUALITY: We spend how much on the NIH and how much on AHQR?

This is far, far too true.

Spending less money on better drugs and more on getting existing therapies to patients would save more lives. That’s the conclusion of a study published by a Virginia Commonwealth University family medicine and public health physician."For every dollar Congress gives the National Institutes of Health to develop blockbuster treatments, it spends only one penny to ensure that Americans actually receive them," said Steven Woolf, professor and director of research in VCU’s Department of Family Medicine and a member of the National Academy of Sciences’ Institute of Medicine. "This reflects, in part, a misperception that the improved drugs, procedures and the like will improve health outcomes, and that does not happen," he said.To illustrate, Woolf used a theoretical disease that claims 100,000 lives a year. If a drug is available that reduces the mortality rate from that disease by 20 percent, it has the potential to save 20,000 lives each year, he said. But if only 60 percent of eligible patients receive the drug, only 12,000 deaths will be averted. So closing the gap in care by making it available to 100 percent of eligible patients would save 8,000 additional lives, Woolf said.But to save the same number of lives by making a better drug and without closing the gap in care, i.e., delivering the better drug to only 60 percent of eligible patients, the drug’s lowering of mortality would have to be increased from 20 percent to 33 percent, he noted. Calling this the "break-even point," Woolf said that is an unrealistic goal for many treatments. In fact, the study showed that the billions invested in statins and anti-clotting drugs failed to reach the break-even point.

And we know that this is not just theoretical.

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