INR Self Testing: Opportunity to comment on a petition to expand Medicare coverage of self-testing - 6/26/2007 to 7/26/2007

Henry I. Bussey, Pharm.D., FCCP, FAHA
June, 2007

As you may know, Medicare covers the use of a fingerstick device for INR self-testing only for mechanical heart valve patients. The three US companies that market an INR self-testing device have successfully petitioned Medicare to consider expanding coverage to include, among other patient groups, those patients with atrial fibrillation (A fib) or deep vein thrombosis (DVT). Medicare is currently accepting public comment on this proposal. Anyone is welcome to comment; you do not have to be a healthcare professional. If you would like to share your views on this issue with Medicare, you can read more about this petition at https://www.cms.hhs.gov/mcd/viewtrackingsheet.asp?id=209. To submit your comments, go to https://www.cms.hhs.gov/mcd/
public_comment.asp?nca_id=209&basketitem=nca%3A00087R%3A209%3AProthrombin+Time+%28INR%29+Monitor+for+Home+Anticoagulation+Management%3AOpen%3A1st+Recon%3A1

Recent information has suggested that improving INR control above 80% time in-range may result in a 50% or more reduction in stroke, heart attack, death, and major bleeding in A. Fib. patients (http://www.clotcare.com/clotcare/improveinrcontrol.aspx). A similar reduction in stroke and major hemorrhage may also be achieved in TIA patients; and some authorities have suggested that such improved anticoagulation may be achieved with frequent self-testing and expert management (http://www.clotcare.com/clotcare/aspirinfortia.aspx).