Re: AANS/CNS Comments on Draft Technical Assessment for Washington State HTA Rereview of Lumbar Spinal Fusion
Dear Mr. Morse:
On behalf of the American Association of Neurological Surgeons (AANS), the Congress of
Neurological Surgeons (CNS), the AANS/CNS Joint Section on Disorders of the Spine and
Peripheral Nerves, and the Washington State Association of Neurological Surgeons
(WSANS), we appreciate the opportunity to provide comments regarding the draft evidence
assessment prepared for the Washington State Healthcare Authority (WCA) Health
Technology Assessment (HTA) program re-review of coverage policy for lumbar spinal
fusion for degenerative disc disease (DDD). We have provided the following remarks based
on our study of the draft report. We add these comments to those that we submitted in
our letter May 20, 2015 regarding the draft Key Questions used for the report. We look
forward to publication of the final report and to the discussion by the Health Technology
Clinical Committee (HTCC) on November 20, 2015.
Cited Literature Does Not Warrant a Policy Change
The document prepared by the Institute for Clinical and Economic Review (ICER) is a
thorough review of the literature. However, as we stated when the HTA program first
suggested that the 2008 HTA Lumbar Fusion for DDD coverage policy be revisited, we do
not believe that there is a substantial change in evidence for this procedure and we do not
support a change to the current policy, which was based on significant stakeholder input
and a robust review by the HTCC. Nevertheless, we would like to provide the following
commentary on various aspects of the ICER report.
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Read full letter here
