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The Perils of EBM
- Potential for unintended consequences
- Justifies coverage decisions based purely on cost without regard for overall effectiveness or value
- Freezes the pace of innovation to the current generation of products
- Discriminates against new technologies
- Leads to prescriptive clinical protocols that do not allow for physician judgment and consideration of patient preferences
- Focuses too narrowly on clinical morbidity or mortality, ignoring a range of other important patient-reported outcomes (ease of use, compliance, functional status)
- Changes to coverage policies occur haphazardly without clear rationale, transparency or accountability
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