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BLUES ASSOCIATION/KAISER PERMANENTE TECHNOLOGY EVALUATION PROGRAM

Executive Summary

BLUES ASSOCIATION/KAISER PERMANENTE TECHNOLOGY EVALUATION PROGRAM will produce about 40 reports per year that will be made available to the public on a subscription basis. At a Sept. 7 press briefing in Washington, D.C., the Blue Cross and Blue Shield Association and Kaiser Permanente announced they will collaborate in assessing existing scientific evidence of new medical technologies. The first joint reports are expected early next year. The move is an expansion of BCBSA's existing Technology Evaluation (TEC) program, which has produced more than 200 assessments since its founding in 1984. The program examines and synthesizes existing scientific evidence to determine the safety and efficacy of new medical technologies, including drugs, biological products, medical procedures and devices. BCBSA and Kaiser expect the collaboration to double the current TEC yearly report output rate of 20. Previous subjects of TEC program assessments include Taxol for breast cancer, colony stimulating factors, stem cell processing techniques, home uterine activity monitoring, positron emission tomography and transcranial doppler ultrasound. In conjunction with the new program, the TEC advisory medical panel will be expanded and will include a majority of independent medical experts with no affiliation with health care payers. The additional members come from the American College of Physicians, the American Academy of Family Physicians and the American Academy of Pediatrics. BCBSA President and CEO Bernard Tesnowski said in a statement: "some of the nation's top health care experts will be working together to provide the best information on what works and what doesn't in medical care." Pharmaceutical industry and device associations also will be involved in the TEC evaluation process. The associations will be notified of which technologies will be evaluated and then will be allowed to give their input, including presentation of data. The new TEC program will offer reports to the general public on an annual subscription basis; the reports previously were made available only to member Blues plans. Health care payers, managed care companies, physicians, medical research institutions, and libraries are expected to be among the subscribers. In addition, the TEC program will also produce a news bulletin and hold forums on technology under assessment. The bulletin, which will cost $200-300 per year for non-TEC assessment reports subscribers, will contain a synopsis of TEC assessment reports as well as news about medical technology. BCBSA expects the actual TEC assessment reports to be "a little more expensive" than the news bulletins. The forums will include presentations by clinical researchers on the scientific evidence on the technology under consideration; industry reps also would be allowed to present data. Desdribing the purpose of TEC assessments in a briefing document, BCBSA says that the reports "are scientific opinions, meant to provide information to those who provide and manage medical care. TEC Program assessments are not recommendations on whether technologies should be considered eligible for reimbursement." In addition, criteria used in assessment "do not address issues of cost, cost containment, comparative cost, or price." "Across the board, these assessments should lead to an improvement of value, if value catches the notion of balance between benefit and cost. With this information, we will have a much better understanding of the magnitude of benefit and the magnitude of cost, so that we can make much better decisions about how technologies ought to be used," David Eddy, MD, the TEC program's chief scientific advisor and senior advisor for health policy and management for Kaiser's Southern California Region, said at the press briefing. Kaiser will continue its own technology assessment program in addition to the agreement with BCBSA. The company also conducts research in the area of outcomes measurement and the formation of clinical practice guidelines.
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