Boston, Mass., April 27, 2016– The Institute for Clinical and Economic Review (ICER) has released a final report, titled Palliative Care in the Outpatient Setting, which evaluates the evidence on the clinical effectiveness and value of palliative care services. The report also includes an overview of the policy landscape surrounding palliative care and incorporates a summary of the March 31, 2016 public meeting of the New England Comparative Effectiveness Public Advisory Council. During the meeting, the independent Council voted on key questions raised in a draft of the report and a policy roundtable of experts in the field discussed how best to apply the evidence to clinical practice and policy.
“Being diagnosed with a serious illness can be a frightening experience for many patients,” noted Steven D. Pearson, MD, MSc, President of ICER. “Our report and meeting highlight the compelling evidence for patients, providers and policymakers showing that palliative care services in the outpatient setting delivered alongside curative treatments improve patient quality of life.”
The New England CEPAC unanimously voted that the current evidence is adequate to show that patients receiving specialist palliative care services experience better outcomes in terms of quality of life and reduction of hospital or emergency department use as compared to patients receiving usual care. Specialist palliative care is typically delivered by a provider with advanced training and certification in the principles of palliative care leading an interdisciplinary team of providers. When voting on palliative care services provided by generalist providers, however, the Council found current evidence to be inadequate to show superiority to usual care, highlighting a need for more research. Based on the evidence of improved outcomes for patients receiving specialist palliative care, paired with evidence that such services can be cost-saving to the health care system, a majority of the Council also voted that specialist palliative care represents a high care value and a high provisional health system value.
During a policy roundtable session following the Council’s votes, key stakeholders, including researchers, providers, payers, and a caregiver representative, discussed policy recommendations to support the application of evidence to policy and practice in the field. Recommendations include designing coverage policies for palliative care services that avoid unnecessary separation of palliative care and curative treatments; considering revisions to licensing and certification requirements to support expansion of the workforce; implementing alternative delivery models to increase access to services; and building awareness of palliative care among both physicians and patients. In addition, a number of future research needs were identified to support broader implementation of effective palliative care programs.
A full summary of the policy recommendations is available in the final report. The report is accompanied by an action guide that provides a compendium of resources to support payers, physicians, patients, and policymakers in implementing the recommendations.
The Institute for Clinical and Economic Review (ICER) is an independent non-profit research institute that produces reports analyzing the evidence on the effectiveness and value of drugs and other medical services. ICER’s reports include evidence-based calculations of prices for new drugs that accurately reflect the degree of improvement expected in long-term patient outcomes, while also highlighting price levels that might contribute to unaffordable short-term cost growth for the overall health care system.
ICER’s reports incorporate extensive input from all stakeholders and are the subject of public hearings through three core programs: the California Technology Assessment Forum (CTAF), the Midwest Comparative Effectiveness Public Advisory Council (Midwest CEPAC) and the New England Comparative Effectiveness Public Advisory Council (New England CEPAC). These independent panels review ICER’s reports at public meetings to deliberate on the evidence and develop recommendations for how patients, clinicians, insurers, and policymakers can improve the quality and value of health care. For more information about ICER, please visit ICER’s website.