WASHINGTON, DC—Buried in the stimulus bill was $1.1 billion earmarked for “effectiveness research.” The American Recovery and Reinvestment Act of 2009 called on the Institute of Medicine to recommend priority topics to be the initial focus of such studies, and the IOM has now issued its list, which puts biologic anti-inflammatory drugs near the top.

That includes Enbrel (Amgen and Wyeth), Remicade and Simponi (Johnson & Johnson and Schering-Plough) and Humira (Abbott Laboratories). The biologics also came in near the top of a similar list issued earlier by the National Institutes of Health.

Comparative effectiveness studies would compare these drugs to each other and to non-biologic alternatives, not just to placebo.

The earmark in the stimulus bill was apparently based on suggestions made by former Senator Tom Daschle during the period before tax and lobbying-related financial issues knocked him out of consideration for Health and Human Services Secretary. It is widely viewed by opponents as a first step toward rationing of care based on financial considerations, as has happened with some of the expensive new biologics in the UK.

Bloomberg News reported that Health and Human Services Secretary Kathleen Sebelius said in a June 27 interview that she would like to see Congress remove restrictions on using cost-effectiveness studies to select drugs and devices for Medicare coverage.