Although Pearl Moore knew she was being nominated to serve on the Obama administration’s Medicare Evidence Development & Coverage Advisory Committee, she still was surprised when she was actually appointed last June.
“It was mostly scientists and oncologists who were chosen,” said Moore, whose career in nursing began more than 35 years ago. “I thought it was nice that a nurse got appointed. It’s nice to be recognized for my expertise.”
MEDCAC provides independent guidance and expert advice to the Centers for Medicare & Medicaid Services on specific clinical topics, supplementing CMS’ own research on “state of the art” technology and science. MEDCAC members are selected based on their background, education and expertise in a wide variety of scientific, clinical and other related fields.
Moore, immediate past CEO and founding member of the Pittsburgh-headquartered Oncology Nursing Society, also serves on the executive board of the National Patient Advocate Foundation, as well as on the board of the Jewish Healthcare Foundation. She recently returned to Pittsburgh from her first MEDCAC meeting in Baltimore, where she was part of a panel of 11 experts reviewing the efficacy and safety of Provenge, a new treatment for prostate cancer.
“We were looking to see if the treatment is reasonable and necessary. We were not supposed to consider whether it was financially feasible,” Moore said.
The committee did find enough evidence to conclude that Provenge is an effective treatment for prostate cancer patients whose cancer has metastasized, Moore said.
Based on the committee’s findings, Medicare may decide to pay for the treatment, the cost of which is $93,000 per patient, according to a Wall Street Journal report.
The FDA had already approved Provenge when MEDCAC was asked to review the drug. The panel’s review sparked controversy as some critics claimed that Medicare has been looking for a justification to refuse coverage in an effort to hold down health care costs.
“There was a controversy as to why we looked at this drug when it was already FDA approved,” Moore said. “I can’t answer that. We were confused, too. It is unusual for Medicare to call a panel to repeat this.”
If Medicare decides to provide coverage for the treatment, Moore believes that private insurers are likely to follow suit.
“It’s a good drug,” Moore said. “The side effects are so minimal; it’s not like chemotherapy.”
Provenge has been shown to extend the life of prostate cancer victims by a median of 4.1 months, and to increase the three-year survival rate by 38 percent.
The benefits of Provenge were “so clear, there was not much to question,” Moore said.
Although Moore retired three years ago, she remains active in both the medical and local Jewish communities. Besides her board positions, she teaches at the University of Pittsburgh School of Nursing, serves on the Jewish Federation of Greater Pittsburgh’s funding committee, as well as the Federation’s commission on aging and human needs.
(Toby Tabachnick can be reached at email@example.com.)