Something old, something new, something borrowed...comparative effectiveness research: a policy perspective.

In the nearly 18 months that have elapsed following enactment of the Patient Protection and Affordable Care Act (PPACA), health care scholars have debated a key portion of the legislation that has the potential to dramatically impact health care. Section 6301 of the PPACA outlines how the federal government will play an increasingly direct role in shaping comparative effectiveness research (CER).1 The inclusion of CER in the PPACA marked a critical step in the advancement of health services research, given that the legislation called for significant federal investment in CER with the ultimate goal of improving the efficiency of the health care system. Here, we briefly review the policy history of CER as it relates to prior efforts in health services research and health technology assessment, discuss the promises and fears associated with CER as outlined in the PPACA, and highlight the important role that the new Patient-Centered Outcomes Research Institute (PCORI) will likely play in advancing both CER methods and evidence generation.