Comparative Effectiveness Research, Courage, and Technological Abandonment

31 Pages Posted: 30 Aug 2011 Last revised: 23 Oct 2011

See all articles by David H. Howard

David H. Howard

Emory University - Department of Health Policy and Management

Yu-Chu Shen

U.S. Graduate School of Business and Public Policy; National Bureau of Economic Research (NBER)

Date Written: August 2011

Abstract

When a major study finds that a widely used medical treatment is no better than a less expensive alternative, do physicians stop using it? Policymakers hope that comparative effectiveness research will identify less expensive substitutes for widely-used treatments, but physicians may be reluctant to abandon profitable therapies. We examine the impact of the COURAGE trial, which found that medical therapy is as effective as percutaneous coronary intervention (PCI) for patients with stable angina, on practice patterns. Using hospital discharge data from US community, Veterans Administration, and English hospitals, we detect a moderate decline in PCI volume post-COURAGE. However, many patients with stable angina continue to receive PCI. We do not find differences in PCI volume trends by reimbursement scheme or hospitals' teaching status, ownership, or degree of vertical integration.

Suggested Citation

Howard, David H. and Shen, Yu-Chu, Comparative Effectiveness Research, Courage, and Technological Abandonment (August 2011). NBER Working Paper No. w17371, Available at SSRN: https://ssrn.com/abstract=1919445

David H. Howard

Emory University - Department of Health Policy and Management ( email )

1518 Clifton Road NE
Atlanta, GA 30322
United States

Yu-Chu Shen

U.S. Graduate School of Business and Public Policy ( email )

555 Dyer Road
Monterey, CA 93943
United States

National Bureau of Economic Research (NBER)

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

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