Actions Taken by the Medical Advisory Panel
The following Assessments were acted on at the February 18, 2010, Blue Cross and Blue Shield Association Medical Advisory Panel (MAP) teleconference:
Gene Expression Profiling in Women with Lymph-Node-Positive Breast Cancer to Select Adjuvant Chemotherapy Treatment
The MAP concluded that use of the 21-gene expression profile (Oncotype DX™) for selecting adjuvant chemotherapy in patients with lymph-node-positive breast cancer does not meet the Blue Cross and Blue Shield Association Technology Evaluation Center (TEC) criteria.
Wearable Cardioverter-Defibrillator as a Bridge to Implantable Cardioverter-Defibrillator Treatment
The MAP concluded that use of wearable cardioverter-defibrillators in patients who are at high risk for sudden cardiac death, but who do not meet the criteria for a permanent implantable cardioverter-defibrillator does not meet the Blue Cross and Blue Shield Association Technology Evaluation Center (TEC) criteria.
Accelerated Radiotherapy after Breast-Conserving Surgery for Early Stage Breast Cancer
The MAP concluded that accelerated whole-breast radiotherapy after breast-conserving surgery for early stage, low-risk* breast cancer meets the Blue Cross and Blue Shield Association Technology Evaluation Center (TEC) criteria; and that accelerated partial breast radiotherapy after breast-conserving surgery for early stage breast cancer does not meet the TEC criteria.
*Note that during the revisions process, staff will be working with Panel members on a specific definition of "low risk," based on the studies providing evidence for this indication.
Cardiac Resynchronization Therapy for Mild Congestive Heart Failure
The MAP concluded that the use of cardiac resynchronization therapy for class I or II congestive heart failure does not meet the Blue Cross and Blue Shield Association Technology Evaluation Center (TEC) criteria.
Percutaneous Vertebroplasty or Kyphoplasty for Vertebral Fractures Caused by Osteoporosis
The MAP concluded that percutaneous vertebroplasty for the treatment of vertebral fractures caused by osteoporosis does not meet the Blue Cross and Blue Shield Association Technology Evaluation Center (TEC) criteria; and that percutaneous kyphoplasty does not meet the TEC criteria.
Special Report: Laboratory Testing to Allow Area under the Curve (AUC)-Targeted 5-Fluorouracil Dosing for Patients Administered Chemotherapy for Cancer
The MAP voted to approve the conclusions and publication of this draft Special Report.
The MAP voted to table the topic “Genetic Testing for Inherited, Nonsyndromic Hypertrophic Cardiomyopathy.” Following revision to narrow the scope of the analysis, the document will be circulated for electronic vote/approval by the Panel.
