The presitigious Institute of Medicine released a report yesterday on the "Future of Drug Safety. Action Steps for Congress." Among the IOM recommendations are two that make perfect sense to me in the wake of the Vioxx and similar flawed drug releases: restrict direct to consumer advertising for the first two years following a new drug release and conduct a follow-up efficacy and safety study five years after the new drug release. The drug manufacturers may not be crazy about the first recommendation because they appear to rely on the blockbuster release approach in order to recoup their investment in new drugs. But an ounce of prevention is worth a pound of cure. The 110th Congress will take up the IOM recommendations next year when Congress must reconsider the user fees that pharmceutical manufacturers pay the FDA for running the new drug approval process.
On Thursday, the IOM released a study on "Rewarding Provider Performance. Aligning Incentives in Medicare." The report finds that pay for performance programs are one of several tools for improving health care quality in the traditional Medicare program. The report recommends that pay for performance program be used to incent improvements not only the quality of care in a particular health care facility but also the in the coordination of care among health care providers. The report offers guidance for pay for performance programs in all payer settings.