Tech­nol­ogy poli­cies should pro­mote in­no­va­tion

Modern Healthcare - - COMMENT -

The Oct. 13 cover story (“De­vice­mak­ers chal­lenged on re­sis­tance to value-based pay­ment,” p. 6) may leave read­ers with the mis­taken im­pres­sion that Ad­vaMed op­poses re­im­burse­ment re­forms de­signed to pro­vide in­cen­tives for re­duced costs and higher qual­ity when in fact, we have con­sis­tently sup­ported such re­forms, go­ing back as early as 2008. Th­ese re­forms may cre­ate an en­hanced mar­ket for med­i­cal tech­nol­ogy that will re­duce cost and im­prove qual­ity of care across episodes of care and will en­able providers to man­age more ef­fec­tively the high cost of chronic ill­nesses.

We be­lieve, how­ever, th­ese re­forms should be cou­pled with safe­guards to pre­vent un­in­tended con­se­quences such as denying pa­tients ac­cess to treat­ments that are clin­i­cally ap­pro­pri­ate but raise short-term costs, or cre­at­ing a chill­ing ef­fect on in­vest­ment in de­vel­op­ing new treat­ments and cures.

While it is ap­pro­pri­ate for in­sur­ers to wish to en­sure cov­ered treat­ments de­liver value, rais­ing the ev­i­dence bar for ini­tial cov­er­age too high or pe­nal­iz­ing providers who are early adopters would be a mis­take. Ro­bust ev­i­dence of safety and ef­fec­tive­ness is al­ready re­quired for ap­proval from the Food and Drug Ad­min­is­tra­tion, and the re­quire­ments for gath­er­ing ex­ten­sive ad­di­tional ev­i­dence prior to cov­er­age can un­nec­es­sar­ily deny pa­tients ac­cess to needed treat­ments. To this end, our com­pa­nies have in­vested sig­nif­i­cant re­sources on ob­ser­va­tional stud­ies, registries and clin­i­cal tri­als to gen­er­ate the ev­i­dence that will demon­strate safety, ef­fec­tive­ness and value.

All treat­ments should be as­sessed on a con­tin­u­ing ba­sis to en­sure that they of­fer the best op­tions for pa­tients, and cov­er­age and treat­ment should be ad­justed ac­cord­ingly, but all par­tic­i­pants in the sys­tem need to rec­og­nize that pa­tients and the pub­lic in­ter­est are best served by adop­tion of poli­cies that pro­mote con­tin­ued med­i­cal in­no­va­tion.

Stephen Ubl Pres­i­dent and CEO

Ad­vaMed Wash­ing­ton

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