对公众意见中包含的证据进行资助,以便为医疗保险国家承保范围的确定提供信息。

Health affairs scholar Pub Date : 2024-05-13 eCollection Date: 2024-06-01 DOI:10.1093/haschl/qxae064
Angela Lu, Robin Z Ji, Marley P D Magee, Joseph S Ross, Reshma Ramachandran, Rita F Redberg, Sanket S Dhruva
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引用次数: 0

摘要

美国医疗保险与医疗补助服务中心(CMS)依靠公众针对国家承保范围确定建议提交的意见来协助该机构确定医疗保险受益人的项目和服务承保范围。在一项横向研究中,我们针对 2019 年 6 月至 2022 年 6 月期间最终确定的所有治疗性医疗器械国家承保范围的确定,对公众意见中提交给 CMS 的引用证据和支持引用证据的资金进行了分析。在 681 份公众意见中,159 份(23%)引用了至少 1 篇可识别的已发表科学期刊论文。在这 159 份公众意见中,有 198 篇文章被引用,其中 170 篇(86%)包含资金声明或作者披露。其中,96 篇(56%)披露了将从医疗保险中受益的制造商提供的资金和/或由从这些制造商处获得资金的作者撰写。总之,大多数国家承保范围确定的公众评论者并未引用已发表的科学期刊论文来支持其立场。在引用文章的评论者中,超过一半的文章是由将从医保中受益的制造商直接资助的。加大对独立的、非行业支持的研究的资助可能有助于提供公正的利弊评估,以支持医疗保险的承保决策。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Funding of evidence included within public comments submitted to inform Medicare national coverage determinations.

The Centers for Medicare & Medicaid Services (CMS) relies on public comments submitted in response to proposed national coverage determinations to assist the agency in determining the coverage of items and services for Medicare beneficiaries. In a cross-sectional study, we characterized the cited evidence and what funding supported the cited evidence submitted in public comments to CMS for all therapeutic medical device national coverage determinations finalized between June 2019 and June 2022. Of 681 public comments, 159 (23%) cited at least 1 identifiable published scientific journal article. Within these 159 public comments, 198 unique articles were cited, 170 (86%) of which included funding statements or author disclosures. Among these, 96 (56%) disclosed funding from manufacturers that would benefit from Medicare coverage and/or were written by author(s) who received funding from these manufacturers. In summary, most public commenters for national coverage determinations did not cite published scientific journal articles to support their positions. Among those who did, more than half of articles were directly funded by manufacturers that would benefit from coverage. Greater funding of independent, non-industry-supported research may help provide unbiased evaluations of benefits and harms to support Medicare coverage decisions.

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