Virginia A. Moyer, MD, MPH; Michael LeFevre, MD, MSPH; Ned Calonge, MD, MPH
Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-2304.
Corresponding Author: Virginia A. Moyer, MD, MPH, American Board of Pediatrics, 111 Silver Cedar Court, Chapel Hill, NC 27514; e-mail, email@example.com.
Current Author Addresses: Dr. Moyer: American Board of Pediatrics, 111 Silver Cedar Court, Chapel Hill, NC 27514.
Dr. LeFevre: Department of Family and Community Medicine, University of Missouri, M224 Health Sciences Center, Columbia, MO 65212.
Dr. Calonge: The Colorado Trust, 1600 Sherman Street, Denver, CO 80203.
Author Contributions: Conception and design: N. Calonge, M. LeFevre, V.A. Moyer.
Drafting of the article: M. LeFevre, V.A. Moyer.
Critical revision for important intellectual content: N. Calonge, M. LeFevre, V.A. Moyer.
Final approval of the article: N. Calonge, M. LeFevre, V.A. Moyer.
Moyer VA, LeFevre M, Calonge N. Is It Time for the USPSTF to Inform—But Not Determine—Coverage?. Ann Intern Med. 2016;165:876-877. doi: 10.7326/M16-2304
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Published: Ann Intern Med. 2016;165(12):876-877.
Published at www.annals.org on 11 October 2016
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Kirsten Bibbins-Domingo, David C. Grossman, Susan J. Curry
U.S. Preventive Services Task Force
October 31, 2016
USPSTF Chair and Vice Chairs Response to Drs. Moyer, LeFevre, and Calonge
On October 11, the Annals of Internal Medicine published a commentary by Drs. Virginia Moyer, Michael LeFevre, and Ned Calonge, entitled, “Is It Time for the USPSTF to Inform—But Not Determine—Coverage?” (1). In this commentary, our esteemed colleagues warn of undue external pressure on the U.S. Preventive Services Task Force, specifically related to recent calls for the Task Force to review the EpiPen as a preventive service.The EpiPen, an epinephrine auto-injection device, delivers life-saving treatment of anaphylaxis but is generally prescribed to people who already have severe allergies. The EpiPen is not a preventive service for asymptomatic people and thus does not fall within the scope of the Task Force. We have not received any nominations for use of the EpiPen to be considered by the Task Force, and if we did, this is not an area where we would undertake making a recommendation.In making their public statements regarding the Task Force, the makers of EpiPen (Mylan; Canonsburg, PA) are hoping to secure no-cost insurance coverage for their device. The Task Force does not make coverage decisions. These decisions are the domain of payers, regulators, and legislators, whereas our independent scientific process remains focused solely on evaluating the evidence about which preventive services have a net benefit. Although the authors raise concerns about external pressure, outside interests affect neither the domain nor the decision making process of the Task Force. We have clear policies and procedures that protect the Task Force from outside influence. We follow the National Academy of Medicine’s widely-accepted standards for developing rigorous and trustworthy clinical practice guidelines (2), as articulated in 2011. The USPSTF has transparent processes in place to avoid or minimize any possible outside influence that could create potential conflicts of interest (see the Task Force’s policies on conflict of interest  and standards for guideline development ).We are deeply committed to improving the health of all Americans and helping ensure access to preventive care. Our role is to evaluate the science on the benefits and harms of a given preventive service so people can make informed decisions with their clinicians about their health care. Our focus on the evidence, along with our open and transparent policies and procedures, are the best safeguard against outside influence. Kirsten Bibbins-Domingo, PhD MD, MAS, Chair, USPSTFDavid C. Grossman, MD, MPH, Vice Chair, USPSTFSusan J. Curry, PhD, Vice Chair, USPSTFReferences1. Moyer VA, LeFevre M, Calonge N. Is it time for the USPSTF to inform—but not determine—coverage? Ann Intern Med. 2016. doi: 10.7326/M16-23042. Institute of Medicine. Clinical Practice Guidelines We Can Trust: Standards for Developing Trustworthy Clinical Practice Guidelines. Washington, DC: National Academies Press; 2011.3. U.S. Preventive Services Task Force. Conflict of Interest Disclosures. 2016. https://www.uspreventiveservicestaskforce.org/Page/Name/conflict-of-interest-disclosures. Accessed October 31, 2016.4. U.S. Preventive Services Task Force. Standards for Guideline Development. 2016. https://www.uspreventiveservicestaskforce.org/Page/Name/standards-for-guideline-development. Accessed October 31, 2016.
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