The long awaited head-to-head trial of Avastin vs. Lucentis in macular degeneration has finally reported results. It pits a $1,500 a dose therapy against a $50, unapproved alternative that most providers think is just as good. We just had that debate over Makena. Recent comments by FDA’s top drug review official suggest there may be another connection.

Comparative Effectiveness Research is a phrase with talisman qualities inside the Beltway -- ascribed with almost magical properties to improve product/treatment choices and drive down health care expenditures. Outside the political sphere, the meaning of the term and concepts about how to effect CER are less clear.

Patient contact programs have an evolving role for drug companies. Originally designed to ameliorate reimbursement and access issues, they are now assuming a new importance in coverage and product selection. They offer a valuable, existing structure for collecting information on the crucial variable -- patient response.