Bookmark & ShareFor Immediate Release: 12/12/2008
HCA Administrator Selects Health Technologies
The HCA Administrator, in consultation with participating state agencies, has selected the third group of health technologies that will undergo the scientific review process and then be presented to the Health Technology Clinical Committee (HTCC) for coverage determinations. After reviewing the recommended technologies and public comments, the following seven health technologies are selected for an evidence based review beginning in 2009.
Selected Technologies
- Sleep Apnea Diagnosis and Treatment
- Calcium Scoring for Cardiac Disease
- Vagal Nerve Stimulation
- Hip Resurfacing
- Bone Growth Stimulators
- Transcutaneous Electrical Neural Stimulation (TENS)
- Glucose Monitoring*
*Glucose monitoring will be set for the latest review to give the most time for imminent studies to be concluded and to ensure careful selection of key questions.
Technologies not selected
Program constraints limit the technologies that can be selected. The prioritization process uses pre-established criteria to identify those technologies that are most appropriate for the health technology assessment process. Technologies that are not selected can be included for future consideration, generally reviewed semi-annually, and remain a concern for agencies. Agencies may prioritize these technologies in applying other evidence based processes and strategies to reduce concerns.
- Osteoarticular Transfer System Cartilage Surgery (OATS procedure)
- Massage Therapy for Chronic Head, Neck and Back Pain
- Essure Permanent Birth Control Procedure
- Breast Cancer Tumor Screening
- Elective Cesarean Section**
**In particular, high Cesarean rates are a priority public health concern. For example, see Dept. of Health report: www.doh.wa.gov/EHSPHL/CHS/CHS-Data/Public/CSectionsInWA.pdf showing rates are nearly double NIH target and some are potentially avoidable. The administrator believes alternate strategies to reduce Cesarean rates, such as use of patient decision aids and other methods should be tried first, but if not successful, it will be reviewed for HTA inclusion.
Technologies eligible for re-review but not selected
Technologies with final coverage decisions are considered for re-review at least once every eighteen months. By law, technologies are selected for re-review only to assess
new evidence that could change a previous determination. The technologies below did not have significant new evidence that could lead to different conclusion.
- Pediatric Bariatric Surgery - no significantly different evidence identified. A national trial is currently underway that may be significant, but is not yet completed.
- Upright MRI – no significantly different evidence identified. Submitted comments included evidence but did not differ significantly from reviewed evidence.
How Technologies are selected for Review
The time and resources required for the assessments limit the number of health technologies selected for a systematic review. The medical devices, procedures, and diagnostic tests are selected based on concerns about whether the technology is safe, whether it works as intended, and whether it is cost-effective, especially when compared to alternatives or where there is a variation in how it is used. State agencies and any interested parties identify potential health technologies of concern. These topics are prioritized with a tool that is based on legislative requirements and criteria widely used in technology assessment priority settings (available on web).
Next Step
Public Comment: A thirty (30) day period to gather public comment on selected topics is next. This public comment period is used primarily to gather information and evidence from stakeholders for our independent evidence reviewer to evaluate. Organizations, researchers, physicians, product manufacturers, professional societies and other members of the health care community have important insights that can assist us. The health care community may have evidence relating to actual practice that is informative. Public comments that provide information, preferably published clinical evidence, relating to a health technology’s safety, efficacy, effectiveness, or cost-effectiveness are most helpful. Public comments that give information on unpublished evidence such as the results of individual practitioners or patients are less rigorous and therefore less useful in the evidence based analysis.
