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Technology Evaluation Center Announces

(CHICAGO – November 8, 2005) – Blue Cross and Blue Shield Association's (BCBSA) Medical Advisory Panel (MAP) met on October 28th, 2005, to review five new technology assessments and two special reports prepared by BCBSA's Technology Evaluation Center (TEC). These assessments evaluate treatment applications for a wide range of conditions such as gastric bypass surgery, asthma, and age-related macular degeneration.

For more than 20 years, TEC assessments have provided objective information to those who deliver and manage medical care. Assessments are based on clinical and scientific evidence and evaluate whether a technology improves health outcomes, such as length of life, quality of life and ability to function. TEC assessments are not recommendations for healthcare by providers or for coverage decisions by health insurance companies. TEC produces 20 to 25 assessments annually.

The following assessments were acted on at the October 28th meeting:

Laparoscopic Gastric Bypass Surgery for Morbid Obesity
TEC reviewed whether the available evidence on whether laparoscopic gastric bypass (LGBY) results in similar improvements in health outcomes as does open gastric bypass (GBY). The MAP concluded that laparoscopic gastric bypass surgery for morbid obesity meets TEC criteria.

Full-Field Digital Mammography
TEC updated the July 2002 Assessment on full-field digital mammography and compared cancer detection, recall and biopsy rates for full-field digital mammography versus screen-film mammography. The MAP concluded that full-field digital mammography meets the TEC criteria.

Exhaled Nitric Oxide Monitoring as a Guide to Treatment Decisions in Chronic Asthma
TEC reviewed whether health outcomes in patients with asthma are improved by using ENO levels to monitor disease activity and assist in management decisions. The MAP concluded that the use of exhaled nitric oxide levels for monitoring patients with chronic asthma does not meet the TEC criteria.

External Counterpulsation (ECP) for Treatment of Chronic Stable Angina Pectoris and Chronic Heart Failure
TEC reviewed whether ECP therapy improves health outcomes for medically refractory chronic stable angina pectoris or chronic stable heart failure. The MAP concluded that ECP treatment of medically refractory angina pectoris and heart failure does not meet the TEC criteria.

Screening for Vertebral Fracture with Dual X-Ray Absorptiometry (DXA)
TEC reviewed whether there is adequate evidence to demonstrate that screening for vertebral fractures using DXA results in improved health outcomes by more appropriately directing treatment. The MAP concluded that screening for vertebral fracture using DXA does not meet the TEC criteria.

Special Report: Current and Evolving Strategies in the Treatment of Age-Related Macular Degeneration
The MAP voted to approve publication of this special report that evaluates the evidence on current and evolving strategies in the treatment of age-related macular degeneration; the special report does not address the question as to whether the TEC criteria are met.

Special Report: Intensity-Modulated Radiation Therapy (IMRT) for Cancer of the Breast or Lung
The MAP voted to approve publication of this special report that evaluates the evidence on IMRT in breast and lung cancer; the special report does not address the question as to whether the TEC criteria are met.

Summaries of these assessments will be available within 4-6 weeks, and full reports will be available within 6-8 weeks on the TEC Web site.

Founded in 1985, TEC pioneered the development of scientific criteria for assessing medical technologies through comprehensive reviews of clinical evidence. TEC is recognized nationally for leadership in producing evidence-based technology assessments.

Each TEC assessment is a comprehensive evaluation of the clinical effectiveness and appropriateness of a given medical technology. These assessments are written by TEC’s core staff.

A 19-member Medical Advisory Panel (MAP), consisting of nationally-recognized experts in technology assessment, clinical research and medical specialties, reviews and approves all TEC assessments. The MAP includes appointees from the American College of Physicians, the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Cardiology, the American College of Medical Genetics, and the American College of Surgeons.

TEC evaluates drugs, devices, procedures and biological products using the following criteria:

1. The technology must have final approval from the appropriate governmental regulatory bodies.
2. The scientific evidence must permit conclusions concerning the effect of the technology on health outcomes.
3. The technology must improve the net health outcome.
4. The technology must be as beneficial as any established alternatives.
5. The improvement must be attainable outside the investigational settings.

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