A coalition of nine organizations dedicated to evidence-based care of venous disease will give several presentations at a July 20 meeting of the Medicare Evidence Development & Coverage Advisory Committee (MEDCAC).
This cooperation among the medical groups is an opportunity for them to provide the Centers for Medicare & Medicaid Services (CMS) a focused, but multidisciplinary, message about the treatment and management of venous disease. This approach has been utilized before with some success.
In the case of a previous MEDCAC meeting on peripheral artery disease, “the inclusion of multiple groups together provided a message that was much clearer, and the outcome was much better for patients and providers, in the sense that CMS acknowledged the data and recognized the benefit of the treatments,” said Neil Khilnani, MD, FACPh, coalition chair and president-elect of the American College of Phlebology (ACP).
The coalition includes the Alliance of Wound Care Stakeholders, American College of Cardiology (ACC), ACP, American College of Radiology (ACR), American Heart Association (AHA), Society for Cardiovascular Angiography and Interventions (SCAI), Society for Vascular Medicine (SVM), Society of Interventional Radiology (SIR), VIVA Physicians (Vascular Interventional Advances). The American Venous Forum (AVF) and the Society for Vascular Surgery (SVS) are not part of the coalition, but will participate at MEDCAC independently.
“Although the coalition does not involve the Society for Vascular Surgery,” said Khilnani, “they are endorsing what we’re doing and we’re endorsing a separate response to the MEDCAC panel that they’re putting forth themselves.”
MEDCAC was “established to provide independent guidance and expert advice to CMS on specific clinical topics.” The committee does not set policy, but instead evaluates the available evidence and makes recommendations to CMS based on its review.
The public meeting will focus on existing treatment strategies for patients with lower extremity chronic venous disease, with the aim of improving health outcomes in the Medicare population as well as identifying gaps in the existing evidence.
The MEDCAC request covers multiple topic areas, including interventions for chronic venous insufficiency, interventions for chronic venous thrombosis and venous obstruction, venous disease evidence gaps, current venous disease treatment disparities, and ways of generating an improved evidence base.
The coalition, which calls itself the Venous Care Partnership, will give six presentations, five that directly respond to the clinical questions put forth by MEDCAC, and one that describes chronic venous disease from the perspective of the patient.
“We wanted to make sure that the patient’s voice was included in our presentations,” said Khilnani. “So our first presentation is going to try to convey what patients have to go through when they deal with chronic venous disease.”
One focus for the coalition’s presentations is to show that, although treatment options for venous disease are several years behind that for arterial disease, progress is being made.
“In the last few years, maybe in the last four or five years, there’s been an incredible increase in the amount of evidence that’s supporting treatment in vein disease,” said Khilnani. “and it’s given us much more clarity, in terms of what treatments to select and which patients benefit from those treatments.”
Presentations are also expected from others, including SVS, AVF, a consortium of original equipment manufacturers, an industry specialist for wound care and a speaker on the use of compression in chronic venous disease.
The coalition plans to continue its partnership after the MEDCAC meeting, including turning the information from the presentations into a paper that can published, potentially in several different journals.
“We hope to stay together in some form, at least initially as a coalition for advocacy, both for patients who have chronic venous disease and for providers in the space,” said Khilnani, “to make sure that the issues that are related to venous care, specifically access to treatments that have been demonstrated to be of benefit to patients, are unimpeded.”
Registration for the MEDCAC meeting is open until July 14, 2016. The meeting will also be streamed via the internet on July 20, 2016.