New CEPAC Members Named for 2014

ICER has announced the new members of the 2014 New England CEPAC (read full press release here).  The 18 members of CEPAC represent a wide variety of backgrounds, specialties and perspectives, and come from all six New England states. CEPAC consists of practicing physicians and methodologists with experience in evaluating and using evidence in the practice of healthcare, as well as patient/public members with experience in health policy, patient advocacy and public health. Representatives of regional public and private payers are included as ex-officio members of CEPAC. A full list of CEPAC members, with brief biographies, is included below.

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Next CEPAC to Address Management Options for Opioid Dependence

The next New England Comparative Effectiveness Public Advisory Council (CEPAC) meeting will take place on  June 20, 2014, in Burlington, Vermont and will address the comparative effectiveness and value of management options for people with opioid dependence.  CEPAC’s public deliberation of the evidence will provide clarity and guidance to clinicians, insurers, and policymakers confronted with decisions on how best to manage opioid dependence and establish policies that minimize the destructive effects of addiction.

Meeting Details

Date: Friday, June 20, 2014
Time: 10:00 AM – 4:00 PM EDT
Location: Burlington, VT (exact location TBD)

Members of the public wishing to attend the meeting must register by June 10, 2014 by visiting here.   The draft evidence report that will form the basis of the CEPAC meeting will be posted to the CEPAC website on or about May 12, 2014.  The CEPAC website also includes instructions for those wishing to submit written comments on the draft report ahead of time, and those requesting the opportunity to make public comments at the meeting.

Fatal drug overdoses have more than doubled in the United States since 1999, with pharmaceutical overdoses – particularly from opioid pain medications such as oxycodone, hydrocodone, and methadone – driving the increase.  Heroin use is also on the rise.  The percentage of people using heroin in the past year more than doubled since 2003Death from drug overdose is now the leading cause of accidental death in the United States, outpacing deaths from homicide, suicide, and traffic fatalities.  In New England and across the country, state leaders have acknowledged the growing opioid addiction epidemic and are searching for strategies to manage dependency while tackling issues related to access, costs, and safety. Governors in New Hampshire, Maine, and Vermont all cited combating growing opioid abuse as a major priority in their State of the State addresses, and Governor Shumlin of Vermont, who devoted his entire speech to rising opioid abuse in his state, will attend the June CEPAC meeting and deliver opening remarks, schedule permitting.


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Report and Action Guide on Supplemental Breast Cancer Screening Now Available

The Institute for Clinical and Economic Review (ICER) today released a new Report and Action Guide to help patients,  provider organizations, and policymakers interpret the evidence on supplemental cancer screening for women with dense breasts. The Report and Action Guide are based on a recent public meeting of CEPAC where the evidence on different screening options was reviewed and recommendations made to guide practice and policy.

The final report  titled, “The Comparative Clinical Effectiveness and Value of Supplemental Screening Tests Following Negative Mammography in Women with Dense Breast Tissue,” discusses the relative importance of dense breasts as a risk factor for breast cancer, considers the relative risks and benefits of supplemental screening for women with different overall breast cancer risk , and compares the clinical effectiveness and value of four technologies used to enhance screening in women with dense breasts:  magnetic resonance imaging (MRI), digital breast tomosynthesis (DBT), hand held ultrasound (HHUS), and automated breast ultrasound (ABUS).  This review builds on a recent effort undertaken by ICER’s other flagship initiative, the California Technology Assessment Forum (CTAF), that considered this topic as it relates to the California population.  The CEPAC report includes an evidence review as well as supplemental information for New England, including regional and national payer coverage policies, region-specific utilization patterns, new evidence, and a budget impact model for New England.

The Action Guide, a companion policy guide to the full report, provides a practical list of evidence-based action steps and resources tailored to help different stakeholders interpret and apply the evidence to policy and practice. Three sections, targeting patients, clinicians, and health insurers, provide information for individuals or organizations looking to apply the best available evidence and expert opinion regarding supplemental cancer screening for women with dense breasts.  In addition, a stand-alone patient information sheet is also available for use by patients and physician practices (available here).


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Helping Research Inform Legislation – The Incidental Economist

Sarah Jane Reed, Sarah Emond, and CEPAC member Austin Frakt recently blogged about the December 2013 meeting on supplemental screening for women with dense breasts.  You can read their blog entry at The Incidental Economist.

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Draft Report on Supplemental Cancer Screening for Women with Dense Breast Tissue Now Posted for Public Comment

Members of CEPAC will convene on Friday, December 13, 2013  in Boston, MA (meeting details here) to deliberate and vote on the effectiveness and value of supplemental screening options for women with dense breast tissue.  The draft report includes a systematic review of the published literature and budget impact analyses using regional data .  To submit a written public comment on the draft report, visit here.  Instructions for how to register to deliver public comment during the CEPAC meeting are available here. The deadline for submitting a written comment or registering to deliver an oral comment is December 11, 2013.

Registration for the CEPAC meeting is free and open to the public, though space is limited. Register to attend via the CEPAC website by December 11, 2013.

Thirteen states have passed legislation requiring that physicians inform women receiving mammograms whether they have dense breast tissue and may therefore need additional screening, with many more poised to introduce similar policies. In New England, Connecticut has enacted a mandatory breast density notification policy, and similar legislation has been introduced in Massachusetts, making the subject of this meeting particularly timely for decision makers both regionally and nationally.

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Draft Voting Questions now posted for public comment

The meeting agenda and draft questions for deliberation for the December 13th CEPAC meeting on supplemental breast cancer screening for women with dense breast tissue are now posted for public comment:

Draft Questions to Guide Deliberation

Members of the public who wish to submit a comment on the questions for deliberation can do so here.


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Action Guide on Community Health Workers (CHWs) Now Available

The Institute for Clinical and Economic Review (ICER) today released a new Action Guide to help provider organizations, payers, and policy makers interpret existing evidence and apply the recommendations of leading policy experts to guide the integration of community health workers (CHWs) into health care systems.  The Action Guide translates the results from the recent CEPAC report titled, “Community Health Workers: A Review of Program Evolution, Evidence on Effectiveness and Value, and Status of Workforce Development in New England,” and provides an associated list of evidence-based action steps and resources tailored to help different stakeholders interpret and apply the evidence to policy and practice. The report formed the basis for the deliberations and votes of the June 2013 CEPAC meeting.

The Action Guide consists of 3 parts with resources and evidence-based steps targeted for 1) the CHW workforce; 2) provider groups and other organizations who employ CHWs; and 3) health insurers. Each section provides information for individuals or organizations looking to apply the best available evidence and expert opinion in the use of CHWs.  Among the topics addressed in the guide are CHW certification and training, recruitment, financing and reimbursement, patient interaction, and evaluation.


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