The policies and politics of creating a comparative clinical effectiveness research center.

As part of the early efforts of the Obama administration to begin health care reform, $1.1 billion for comparative effectiveness research was included in the stimulus bill. Although this amount can be considered as an initial down payment, difficult issues such as where to place an ongoing effort, the role of such research in informing clinical decision making or reducing health care spending, and the governance to ensure full involvement by stakeholders have not yet been resolved. Legislation proposed over the past two years offers some insights into the options available going forward.