Comparative Effectiveness: Avastin vs Lucentis

What have you learned or been taught about evidence-based medicine, translational medicine, and implementation science, so far? What is your understanding of the evidence pyramid? Use an Internet search engine to look up the evidence-based medicine pyramid and study the images associated with that term and see the variety of images out there.  What observations or comments can you provide based on this review? Do you think that translational medicine and implementation science are emergent disciplines or are they old wine in new bottles? Why? Review Case 8: Comparative Effectiveness: Avastin vs Lucentis.  Respond to at least two of the questions below: If you were a retina specialist, how would the data in this case affect your drug procurement processes, your clinical practices, and your recommendations to patients? Would that decision be affected by the fact that Medicare allows a markup of 6% on outpatient injectables?  If you had AMD, what treatment choices would you make after reading this case?  Would your choice depend on whether you had significant copays or other out-of-pocket expenses related to eye injections?  If you were a CMS official, what coverage-related policies would you promote? If you were a legislator with oversight of a state Medicaid program, how would you respond to this case? If you were a policy analyst, what would you recommend and to whom?  What policy changes might be needed to support government-sponsored initiatives related to CER and evidence-based medicine? If you were an insurer, how would you respond to the recommendation that insurers facilitate CER research? What forms might such facilitation take?

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