Comparative Effectiveness vs. MicroSegmentation

In an interesting, if not over my head conversation, Robert Goldberg (VP of the Center for Medicine in the Public Interest) talks about comparative effectiveness which effectively looks at the costs of treatments versus the outcomes.  From a business perspective, this makes all the sense in the world.

On the flipside, I certainly understand his key arguement which points out that generalizations don’t work.  A drug that doesn’t work generally might work for a certain minority segment.  I pulled a few quotes below, but you can read the whole Washington Times editorial here.  This is why genomics is so important.  Once we understand how drugs and treatments vary by genes and understand what genes each person has, we will be much more effective at treatment and outcomes.  (I am not so sure about cost, but we will table that for now.)

• “opposed approval of Bidil, which reduced deaths from stroke among blacks by 43 percent but is making money peddling the ALLHAT regimen to doctors even though it increases stroke related death among blacks by 40 percent”
  
• “The comparative effectiveness crowd hates gene testing because it identifies individual differences that screw up their ability to make sweeping judgments about what’s best for everyone.”