Should Medicare cover a virtual colonoscopy?

Merrill Goozner writes that the Agency for Healthcare Quality and Research (AHRQ) – the somewhat impotent American version of a comparative effectiveness body – has concluded that CT, or “virtual”, colonoscopies are not cost effective. I’ve written in the past about how the media hype surrounding the test needs to be tempered.

The price of the scans need to go down by about $200 before it can compete with other modalities of colon cancer screening, such as a traditional colonoscopy. The main reason is that a traditional endoscopy is still needed if any suspicions lesions are found on the CT.

Medicare has to decide whether to cover virtual colonoscopies. This has the makings of a huge turf war, with radiologists wanting to get a piece of the lucrative colon cancer screening pie.

Medicare has traditionally covered tests without much regard to cost effectiveness. Mr. Goozner wonders if that approach will hold up in the current economic climate:

In the past, Medicare has said that “too expensive” is not a reason to dismiss a new technology as neither reasonable nor necessary, even when there are less expensive and equally effective alternatives available. It will be interesting to see if that definition still holds as the nation enters a new, more cost-conscious era.

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