CMS' coverage with evidence development could help Medicare beneficiaries make better decisions about medications and medical technologies if the policy expedites adoption of new drugs and technologies and improves information about efficacy over longer periods of time, according to a paper published in Health Affairs. Medicare in 2005 issued a draft guidance for CED, a policy that would link coverage of some treatments to beneficiaries' participation in a registry or clinical trial.
Sean Tunis, director of the Center for Medical Technology Policy and a senior fellow with the Health Technology Center in San Francisco, and Steven Pearson, a senior scientist at NIH, write that there are five main areas of change that would improve CED:
- Clarifying standards when evidence about a drug or technology is sufficient to make it eligible for Medicare coverage as "reasonable and necessary" and when the evidence dictates that it should be considered for CED;
- Developing a system to prioritize the most important new drugs and technologies for CED acceptance;
- Ensuring that data gathered under CED is accurate and useful to decision makers;
- Guaranteeing the safety of beneficiaries under CED program; and
- Providing "substantial and sustainable" funds for CED (Tunis/Pearson, Health Affairs, September/October 2006).