USPSTF takes first steps toward CTC reimbursement

Last month, the U.S. Preventative Services Task Force (USPSTF) included CT colonography (CTC) in a draft research plan for colorectal cancer screening, setting the stage for potential Medicare reimbursement of the procedure in the future.

The draft research plan must receive a positive rating in order for Medicare to cover the procedure, and hopefully it does; lives could be saved if CTC screening becomes more widely available.

CTC has a number of advantages over traditional optical colonoscopy, including being a shorter, less costly procedure.

But the most important aspect of CTC is that patients prefer it, which means they’ll be more likely to actually go through with screening. CTC is non-invasive and doesn’t require sedation, and studies have shown this matters to patients. Of those who’ve experienced both CTC and optical colonoscopy, 77.1 percent preferred CTC. More than 90 percent labeled their overall experience with CTC as good or excellent (Am J Roentgenol. 2012 Jun;198:1361-6).

Cost is a factor, however, and another study found that while most patients are willing to undergo CTC when informed about the procedure, 70 percent said they would not pay out-of-pocket if insurance did not cover the study (Am J Roentgenol. 2010 Aug;195:393-7).

Colon cancer is one of the deadliest cancer in the U.S., however screening can save lives. When colon cancer is detected and treated early, the five-year survival rate is about 90 percent.

This is why stakeholders, including the Medical Imaging & Technology Alliance (MITA), have come out so strongly in favor of CTC and the USPSTF’s movement on this issue.

“We are pleased that USPSTF has initiated a systematic review of this demonstrated life- and cost-saving imaging technology,” said Gail Rodriguez, executive director of MITA, in a statement. “An abundance of evidence confirms that CT colonography is a safe, cost-effective diagnostic tool, particularly for patients who are resistant to traditional, optical colonoscopy. The release of this draft Research Plan is an essential first step toward expanding Medicare beneficiary access to early detection and treatment and ultimately turning more colon cancer patients into survivors.”

The draft research plan can be viewed here.

-Evan Godt
Editor – Health Imaging