包括在公众意见中提供的证据的资助,以告知医疗保险国家覆盖范围的决定
Angela Lu1,2, Robin Z Ji1,3, Marley P D Magee4
1University of California, San Francisco School of Medicine, San Francisco, San Francisco, CA 94143, United States.
Health affairs scholar
|June 26, 2024
概括
大多数关于医疗器械的医疗保险覆盖决定的公众评论都没有引用科学文章. 当引用时,超过一半的这些文章是由寻求覆盖的制造商资助的,这可能会对覆盖决策产生偏见.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗器械政策 医疗器械政策
- 基于证据的医学基于证据的医学.
背景情况:
- 医疗保险和医疗补助服务中心 (CMS) 使用公众评论来确定国家覆盖范围 (NCD).
- 公共评论为医疗保险受益人提供医疗用品和服务的覆盖决定提供信息.
- 了解公众评论中的证据基础对于公正的报道评估至关重要.
研究的目的:
- 在治疗医疗器械非传染性疾病的公开评论中描述引用的证据.
- 确定支持这些公开评论中引用的证据的资金来源.
- 评估提交给CMS的证据中的潜在利益冲突.
主要方法:
- 2019年6月至2022年6月期间完成的治疗医疗器械非传染性疾病 (NCD) 公众评论的横截面研究.
- 在公众评论中识别和分析引用的科学期刊文章.
- 检查了资金声明和作者披露的潜在行业影响力.
主要成果:
- 在681份公开评论中,只有23%引用了可识别的科学文章.
- 在被引用的198篇独特文章中,86%的文章有资金声明或披露.
- 56%的引用文章是由受医疗保险覆盖的制造商资助的个人资助或撰写的.
结论:
- 大多数公众评论员没有以发表的科学文献来支持他们的立场.
- 引用的证据中有很大一部分是由制造商资助的,这些制造商对覆盖决策有既得利益.
- 需要增加对独立研究的资金,以进行支持医疗保险覆盖的公正评估.
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01:29Documentation in Long-Term and Home Healthcare Setting
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