The following editorial was published in the Des Moines Register on July 11:
“Stem cells have been called everything from cure-alls to miracle treatments. But don’t believe the hype. Some unscrupulous providers offer stem cell products that are both unapproved and unproven.” — U.S. Food and Drug Administration
Kaiser Health News recently reported a Des Moines-based stem cell company has persuaded 100 employers, including Hy-Vee and Meredith Corp., to include its services in health insurance plans. The Des Moines Register published the story.
Before some workers can undergo knee replacements, they must first visit a Regenexx clinic. The company claims injections of a patient’s “own cells” can help avoid more expensive orthopedic surgery. It says its treatments are exempt from approval by the U.S. Food and Drug Administration, a federal agency that strongly cautions consumers about unapproved treatments.
The story ruffled some feathers in Iowa.
Regenexx responded to a Register editorial writer’s follow-up questions with a link to a blog written by founder Dr. Chris Centeno criticizing the Kaiser reporting as incomplete and “one-sided.”
What most of us are left wondering: Do the treatments offered by Regenexx work?
It depends on whom you ask. It depends on what online testimonials you read and believe.
And therein lies the real conundrum in all this: Decisions about medical treatment are too often influenced by anecdotes, testimonials, advertising and the advice of daytime talk-show hosts. Instead, these decisions should be rooted in scientific studies and objective data.
But such unbiased information is frequently not readily available to consumers.
Yes, the FDA approves drugs and medical devices, tracks adverse events and issues recalls on dangerous products. Consumers have some assurances about the safety and efficacy of medications and pacemakers.
But in other areas, unbiased information is sparse to nonexistent. Good luck, for example, finding information about a doctor’s performance, reliability and outcomes.
Patients can read online reviews and check with the state medical board for sanctions, but they cannot know how cancer patients of a specific oncologist fare a few months or years after treatment. There is no public reporting system for complication rates of a certain anesthesiologist or ophthalmologist. Orthopedic surgeons may have no idea how well a patient did a decade after a broken bone or joint replacement.
Just because a treatment has been used for decades does not mean it’s the most effective treatment. Just because a doctor has been practicing for years does not mean she’s good.
And just because an employer is covering a procedure in a medical plan does not mean it’s effective.
The Kaiser story underscores the need for evidence-based health care rooted in unbiased, scientific studies and reliable data collected over time. Americans need more information when making decisions that affect health and life.
Health insurers, including Medicare and Medicaid, are in the best position to step up and gather information about outcomes. They know what procedures patients have undergone and can survey them years later to find out about pain, function and complications.
Gathering outcome information is the way to find out what treatments work best — something everyone, including doctors, insurers, taxpayers and patients need to know in a country that spends more than $3 trillion on health care annually.
The Kaiser story also underscores the struggles faced by employers that offer health insurance to workers. They are doing the right thing by providing health insurance, but are also working hard to contain costs.
That could drive them to consider covering medical alternatives that have not been approved by legitimate authorities, said David Lind, president of the Clive-based Heartland Health Research Institute. “Well-intentioned employers could expose their employees to potentially harmful care.”
People suffering from severe pain are desperate for relief. They may try anything, including remedies advertised on television or recommended by their bosses.
That is not how decisions about medical care should be made in this country.