To the Editor: In their Commentary, Dr Pearson and colleagues1 discuss the ethics of the relatively new policy by the Centers for Medicare & Medicaid Services (CMS) for coverage with evidence development (CED). This has been required for expanded coverage of such technologies as implantable cardioverter-defibrillators2 and carotid stent systems.3 I am concerned about the authors' assertion that differential access to CED technologies by various segments of the Medicare population is “a regrettable practical reality but does not constitute an injustice.”
Groeneveld PW. Medicare Requirement for Research Participation. JAMA. 2006;296(24):2923–2925. doi:10.1001/jama.296.24.2923-b
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