MedCAC To Ponder Cost Question At Virtual Colonoscopy Meeting
This article was originally published in The Gray Sheet
Executive Summary
CMS wants an advisory board to consider the costs per life years saved for computed tomography colonography at a Nov. 19 meeting
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Cost-Effectiveness Policy In Brief
CMS coverage chief calls for cost consideration: The Medicare agency does not consider the cost of an item during the coverage process, but "we should," says Steve Phurrough, director of the coverage and analysis group in the CMS Office of Clinical Standards and Quality. Speaking Dec. 3 at a conference on value-based purchasing led by the ECRI Institute, Phurrough says that the high cost of a device might lead the coverage team to consider the technology for a potential national coverage determination, but CMS does not evaluate cost in the national coverage process. The policy may change in the future, but the agency will wait to "see what happens in the months ahead, as Congress and the new administration give us whatever guidance they're going to give us." Phurrough and other leaders from government, industry, medicine and academia met for the two-day conference in Washington, D.C., to address the role of comparative effectiveness, cost effectiveness and pay-for-performance in health reform. Recently, CMS asked its Medicare Evidence Development and Coverage Advisory Committee to consider cost as part of a national coverage determination process for computed tomography colonoscopy (1"The Gray Sheet" Nov. 3, 2008, p. 10)
Cost-Effectiveness Policy In Brief
CMS coverage chief calls for cost consideration: The Medicare agency does not consider the cost of an item during the coverage process, but "we should," says Steve Phurrough, director of the coverage and analysis group in the CMS Office of Clinical Standards and Quality. Speaking Dec. 3 at a conference on value-based purchasing led by the ECRI Institute, Phurrough says that the high cost of a device might lead the coverage team to consider the technology for a potential national coverage determination, but CMS does not evaluate cost in the national coverage process. The policy may change in the future, but the agency will wait to "see what happens in the months ahead, as Congress and the new administration give us whatever guidance they're going to give us." Phurrough and other leaders from government, industry, medicine and academia met for the two-day conference in Washington, D.C., to address the role of comparative effectiveness, cost effectiveness and pay-for-performance in health reform. Recently, CMS asked its Medicare Evidence Development and Coverage Advisory Committee to consider cost as part of a national coverage determination process for computed tomography colonoscopy (1"The Gray Sheet" Nov. 3, 2008, p. 10)
House members push for CT Colonography NCD
Six House members, led by Rep. Barbara Cubin, R-Wyo., want CMS to approve a national coverage determination for computed tomography colonography as a screening test for colorectal cancer - a proposal that the agency will be taking up at a Medicare Evidence Development & Coverage Advisory Committee meeting on Nov. 19 ("1The Gray Sheet" Nov. 3, 2008, p. 10). Cubin, along with Reps. Ed Towns, D-N.Y., Chip Pickering, R-Miss., Charlie Wilson, D-Ohio, John Sullivan, R-Okla., and Tammy Baldwin, D-Wis., told CMS in an Oct. 24 letter that allowing CTC, also known as "virtual colonoscopy," to be covered under an NCD would provide a cheaper alternative to traditional optical colonoscopies for patients and would result in more patients getting screened for cancer