TO THE EDITOR:

We agree with Ms. Jung that an interdisciplinary "consumer research approach" is an excellent idea but that it is unlikely to be implemented in the near future. As such, we believe that the Task Force's recommendations [1], which bring together more than 2 years of effort by 30 knowledgeable stakeholders, lay the groundwork for a "good housekeeping seal of approval" that can help to reduce bias in all forms of clinical economics.

We also agree with Sacristan and colleagues that Dr. Evans' editorial [2] completely misses the point. As noted in our report, the 13 pharmaceutical sponsors made "no strings attached" grants to the University of Pennsylvania so that we could conduct our consensus panel freely and without undue outside influence. These companies also agreed to limit their representation on the Task Force [1]. We vigorously attempted to secure funding from various branches of the government, foundations, and other corporate sources; only the pharmaceutical supporters saw the importance of this issue, issued grants, and gave up control of the Task Force process.

Furthermore, we agree that potential bias exists whenever research is done. For example, research findings that suggest slowing the development and adoption of certain expensive new medical technologies would serve the federal government's goal to reduce Medicare and Medicaid spending. If this research were supported by the National Institutes of Health, then why shouldn't it, too, be subject to skepticism? It is exactly these potential biases that our Task Force findings seek to minimize so that research can be evaluated on its technical merits rather than its contractual underpinnings.

Because of time constraints, this response to the published letters is limited to the undersigned and in no way reflects the full thinking of the entire Task Force.