Futurescapes: evidence expectations in the USA for comparative effectiveness research for drugs in 2020.
OBJECTIVE
Explore key factors influencing future expectations for the production of evidence from comparative effectiveness research for drugs in the USA in 2020 and construct three plausible future scenarios.


METHODS
Semistructured key informant interviews and three rounds of modified Delphi with systematic scenario-building methods.


CONCLUSIONS
Most influential key factors were: health delivery system integration; electronic health record development; exploitation of very large databases and mixed data sources; and proactive patient engagement in research. The scenario deemed most likely entailed uneven development of large integrated health systems with pockets of increased provider risk for patient care, enhanced data collection systems, changing incentives to do comparative effectiveness research and new opportunities for evidence generation partnerships.
Center for Medical Technology Policy, World Trade Center Baltimore, 401 East Pratt Street, Suite 631, Baltimore, MD 21202, USA.
Donna A
DA
Messner
Patient-Centered Outcomes Research Institute (PCORI), 1828 L Street, NW, 9th Floor, Washington DC 20036, USA.
Penny
P
Mohr
Office of Health Economics; 7th Floor, Southside, 105 Victoria Street, London, SW1E 6QT, UK.
Adrian
A
Towse
D057186:Comparative Effectiveness Research / Q000191:economics* / Q000379:methods* / Q000639:trends; D016208:Databases, Factual; D003695:Delivery of Health Care; D003697:Delphi Technique; D055808:Drug Discovery / Q000191:economics* / Q000379:methods* / Q000639:trends; D057286:Electronic Health Records; D006801:Humans; D007407:Interviews as Topic; D010358:Patient Participation; D055553:Prescription Drugs / Q000191:economics*; D014481:United States
D055553:Prescription Drugs
comparative effectiveness research; data mining; database networks; drug development; electronic health records; future scenarios; healthcare costs; healthcare integration; healthcare reform; patient activism; patient-centered outcomes research; research partnerships; risk-sharing