Medicare changes policies in response to comparative effectiveness research

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The Medicare administrator for most of New England has changed policy to approve coverage of Transcranial Magnetic Stimulation (TMS) for people suffering with treatment-resistant depression. The new policy, effective in March, reverses a November 2011 policy of non-coverage and is the first in the nation Medicare TMS coverage policy. It is estimated that 14 million Americans suffer from major depressive disorder in a year; 30 to 50% of patients who seek treatment do not respond to medication. TMS is a relatively new alternative to electroconvulsive therapy with less severe side effects for patients whose depression has not responded to medication. In December CEPAC, a public New England comparative effectiveness council of clinicians, researchers and patient advocates, met to consider evidence of the effectiveness and efficiency of TMS among other treatments. The CEPAC vote to approve TMS in December was cited by the Medicare contractor in its decision to change policy and approve coverage.