Many of you are aware of a post on President Trump’s social media platform implying that the administration would bring an end to the skin substitute LCD(s) and suggesting that their implementation will lead to more DFU amputations. You can see the post on Jeanne Pinder’s recent Clear Health Costs site. I didn’t feel like giving it any more views by posting it.
I don’t have any inside knowledge as to whether the LCDs will be implemented on April 13. However, if they are, I am confident it will not lead to an increase in diabetic amputations. Like it or hate it, the products covered by the LCD(s) have prospective clinical trials showing that they heal DFUs. Patients with DFUs will not be harmed by the implementation of the LCD(s) simply because the options for treating DFUs are limited to more than a dozen products with good clinical data. The LCDs will hurt the revenue stream for manufacturers whose products are priced more than 1,000% higher than the ones on the covered list (even though price was not a criterion for getting on the list).
If the post means that President Trump’s administration is paying attention to the needs of patients with chronic wounds, that is fantastic news! Frankly, I don’t think the current administration (with their laser focus on government spending) will be at all pleased when they hear the whole story about what’s going on in the world of “skin substitutes.” My popcorn is coming out of the microwave – this will be fun to watch…
Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes through quality driven care. Please visit my blog at CarolineFifeMD.com and my Youtube channel at https://www.youtube.com/c/carolinefifemd/videos
The opinions, comments, and content expressed or implied in my statements are solely my own and do not necessarily reflect the position or views of Intellicure or any of the boards on which I serve.
This whole fiasco is a black eye on industry and clinicians in Wound Care. Its a shame becasue the ones that will get hurt are the patients.
Insightful as always. Please pass the butter. Thank you
There’s no way you believe price wasn’t a factor in getting on the approved list. And yes, of course, patients will be harmed by limited access and the lack of incentive for clinicians to visit immobile patients at home. Would you do it for $90, minus tolls, gas, and other expenses? That said, $4,000 per centimeter is outrageous and indefensible. There’s a reasonable middle ground—say, $800 to $1,100 per centimeter—that could encourage manufacturing, speed to market, and motivate physicians to provide in-home care
Agreed. I have to strongly disagree with Dr. Fife. There is a clear difference between the efficacy of various CTPs. It is quite apparent to me that Dr Fife does not have personal hands on experience with this (those of us who do know it is true). Whereas companies charging $3000+ per unit for CTPs is outrageous, it is not a reason to slash almost all available CTPs to “save money.” We know that the cost of taking care of an amputee (not to mention the drastically increased mortality rate) will far outweigh any cost savings from the proposed new LCD.