Task Force Addresses Access to New Neurotech Therapies

by James Cavuoto, editor

A newly organized task force representing clinicians, health service providers, payers, and neurotechnology vendors is seeking to expand the availability of neurotechnology devices for individuals with neurological and psychiatric disorders. The National Task Force on Consumer Access to Emerging Neurotechnologies held its inaugural meeting earlier this year and recently published a whitepaper specifically targeted to severe depression. Cyberonics, Inc., the Houston, TX manufacturer of vagus nerve stimulation systems, provided funding for the initial meeting but the group is currently seeking sponsorship from other neurotech device vendors.

The members of the new task force include several clinicians and academics involved with treatment-resistant depression, including Roger Haskett, a professor of psychiatry at University of Pittsburgh, Lawrence Cohen, a professor of pharmacotherapy at Washington State University, and Darin Dougherty from Massachusetts General Hospital. Also serving are representatives from Aetna Behavioral Health, Cigna Healthcare, PacifiCare Behavioral Health, United Behavioral Healthcare, and the U.S. Social Security Administration. Nonprofit organizations such as the Depression & Bipolar Support Alliance, the National Alliance on Mental Illness, and the World Federation for Mental Health are also represented on the task force.

The stated goals of the task force are to increase understanding of neurotechnology within the payer, provider, and consumer advocacy communities; to promote standardized clinical decision making criteria, consumer access, and reimbursement policies; and to promote parity and equity in consumer access to neurotechnology for individuals with mental health, behavioral health, and neurological conditions.

At the inaugural meeting, the task force focused specifically on depression, examining the state of current research on treatment efficacy, a standardized definition for treatment-resistant depression, the costs associated with TRD, and standards of scientific evidence.

The members reported that existing depression treatment guidelines are outdated and do not address TRD. “It is clear that no one medication (or combinations of medication and/or cognitive therapies) is a panacea for all consumers, and the clinical predictors of treatment selection are weak,” the group reported in its whitepaper. The publication pointed out that current guidelines do not address interventions for the 33 percent of individuals who do not respond to currently available therapies.

The task force reported that the annual costs to the U.S. associated with depression are about $83 billion, of which $26 billion relates to treatment costs, with the remainder due to lost productivity and lost earning resulting from suicide. Treatment costs for individuals with TRD were found to be six times greater than for those with treatable depression. The group also discussed the use of randomized controlled trials, currently the gold standard at the FDA, and advocated alternatives such as practice-based ­evidence.