Medicare OKs lung volume reduction surgery

Tuesday, September 30, 2003

BALTIMORE - With the conclusion of a five-year study that supports the effectiveness, safety and cost-effectiveness of lung volume reduction surgery (LVRS), CMS intends to make the surgery available to Medicare beneficiaries suffering from severe emphysema.

LVRS is designed to improve overall lung function for some patients with emphysema. The procedure entails removing diseased portions of the lung to provide space for remaining healthy lung tissue.

Results of the landmark study - the National Emphysema Treatment Trial - indicated that, on average, patients who undergo LVRS with medical therapy are more likely to function better after two years and do not face an increased risk of death compared with those who receive medical therapy only.

Although findings from the study suggest the estimated three-year cost-effectiveness ratios for LVRS as compared to medical therapy alone are unfavorable, CMS believes the benefits of LVRS outweigh the costs and LVRS is likely to compare favorably with other surgical procedures when additional years of data are available.

A national coverage determination (NCD) for LVRS will go into effect after CMS publishes its decision in the Federal Register.