In 2009, CMTP implemented a pilot project to test the viability of a private-sector approach to coverage with evidence development (CED), in which health plans offer provisional coverage for an intervention while collecting the data necessary to generate sufficient appropriate evidence to inform coverage policy. On May 6, 2009, CMTP convened a workgroup of cardiology experts in San Francisco to select the three most appropriate topics for a CED initiative from a list of 10 emerging cardiac technologies.
The initial list of candidate cardiac technologies was generated through a review of horizon-scanning literature and recent technology assessments, nominations by members of the workgroup and external stakeholders, and the identification of technologies failing to receive widespread favorable coverage decisions. Technologies were evaluated against a set of criteria generated by CMTP staff and consultants, which included considerations of the potential clinical benefit (both net benefit and to individual patients), the state of current clinical evidence, cost-effectiveness, and demand for the technology within the health care community.
CMTP staff narrowed down the initial list of ~40 cardiac technologies to a list of ten. Workgroup members were provided with extensive background information on each of the 10 promising cardiac technologies that were being considered for the CED pilot, and asked to review each of them against a set of criteria. At the May 6th meeting, workgroup members were given the opportunity to discuss each technology, and address questions and concerns. At the end of the meeting, workgroup members were asked to select technologies most promising for CED, and a relatively high degree of consensus emerged.