Former chairs of the U.S. Preventive Services Task Force (USPSTF) said guidelines from the group should inform -- not determine -- insurance coverage.
In a new commentary published in the Annals of Internal Medicine, former chairs Drs. Virginia Moyer, Michael LeFevre, and Ned Calonge present Mylan's attempt to lobby the USPSTF to develop guidelines on its EpiPen as an example of the pitfalls of linking the task force's recommendations to reimbursement.
The firm's attempt to influence the panel violates the integrity of the USPSTF's process, the authors wrote. The American public is best served by an independent scientific process free from advocacy and political pressure, they added.
"If the only way to assure such independence is to sever the direct linkage to coverage, then it may be time to consider that option," they wrote.
Under the Affordable Care Act (ACA), insurers must cover without co-pay interventions graded as an "A" or "B" by the USPSTF. The task force uses rigorous assessments of conflict of interest to ensure unbiased decisions about preventive services. The panel does not consider costs or coverage when making recommendations, only the scientific assessment of benefits and harms.
In medical imaging, the USPSTF's recommendations have played into the debate over whether services such as mammography and CT colonography should receive Medicare and Medicaid reimbursement.
