aamc.org does not support this web browser.
  • Washington Highlights

    GAO Report on Comparative Effectiveness Research and PCORI, HHS Activities

    Anne Berry, Lead Specialist, Implementation Research & Policy

    On Mar. 23, the Government Accountability Office (GAO) published findings of its review of the Patient-Centered Outcomes Research Institute (PCORI) and the Department of Health and Human Services’ (HHS) use of the Patient-Centered Outcomes Research Trust Fund, established in 2010 to fund activities related to comparative effectiveness research (CER).

    In addition to assessing award and expenditure data, descriptions of activities, and other previously published resources, the GAO conducted interviews with PCORI staff, HHS officials, and other relevant stakeholders. In general, these interviewees supported the work and priorities of PCORI. As the report notes, “Most stakeholders also told us that PCORI’s efforts to engage patients in the research process has changed the way research is conducted for the better, such as prioritizing research outcomes that are most meaningful to patients.”

    In its review GAO found that between 2010 and 2017, PCORI has committed approximately $2 billion in awards. The majority of this funding (around $1.6 billion) has gone toward research awards. Additional funding included $325 million for using health data for research, $93 million for engagement and workforce awards, and $12 million to support dissemination and implementation of research findings (as more studies are completed, funding for dissemination and implementation activities is expected to increase by an additional $91 million between 2018 and 2021).

    The report provides an overview of the status of research projects and types of studies being funded. As of 2017, PCORI has funded 543 research projects, of which 53 are complete. The research process often takes several years, so most of the projects are still underway. By the end of 2018, PCORI anticipates that over 200 more projects will be completed, a number that will increase through 2024 when the last of the remaining studies is expected to end.

    As the report states, “PCORI research awards have increasingly focused on conditions that impose a substantial health or financial burden on patients and the healthcare system.” The following five conditions have received the greatest amount of PCORI research funding: mental and behavioral health, including substance use disorders; cancer; cardiovascular disease; neurological disorders; and multiple chronic conditions.

    In addition to highlighting PCORI’s activities, the report also details both the Agency for Healthcare Research and Quality (AHRQ) and the Office of the Assistant Secretary for Planning and Evaluation’s (ASPE) use of the Patient Centered Outcome Research Trust Fund to advance CER. Notably, between 2011 and 2017, AHRQ obligated $260 million toward CER dissemination and implementation activities and $94 million for training researchers in conducting CER (and plans to obligate an addition $93 million in dissemination and implementation efforts and another $14 million through 2020). Also, between 2011 and 2017, ASPE has obligated $85 million for building data capacity for conducting CER (and plans to obligate additional $6 million through 2019).