publication date: May. 9, 2014


By Matthew Bin Han Ong

An advisory panel for the Centers for Medicare and Medicaid Services expressed low confidence in low-dose computed tomography as a method for screening for lung cancer in the Medicare population.

Evidence is inadequate to ensure that benefits of the procedure would outweigh harms, the Medicare Evidence Development & Coverage Advisory Committee said at the hearing April 30.

Panel members gave low average confidence scores in response to two questions focusing on harms—2.22 for whether there is adequate evidence for significant benefit over harm, and 2.33 for whether harm will be minimized in the Medicare population.

“I got stuck on ‘adequate’, and I just didn’t feel that there is really adequate evidence at this time,” said MEDCAC member Jo Carol Hiatt, chair of the Inter-Regional New Technology Committee at Kaiser Permanente. “It’s promising, but we certainly need more information before making a broad statement about benefit to the Medicare population.”

The panel votes in a manner that differs from the FDA Oncologic Drugs Advisory Committee, which usually votes up-or-down on the approval questions. In contrast, MEDCAC members are asked to rate the benefit-harm ratio on a five-point scale, after which the committee members’ scores are averaged.

In the case of CT screening, the two most important scores fell into the low confidence range.

It is unclear how CMS will interpret MEDCAC’s recommendation, but insiders say it’s plausible that low-dose CT screening for lung cancer could be denied coverage.

Committee members largely based their votes on … Continue reading 40-19 CMS Advisors Express Low Confidence in LDCT

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