News & Commentary

USPSTF Independence Needs Protecting


Dismayed by Mylan’s moves to have its EpiPen classified as a preventive service, three former leaders of the U.S. Preventive Services Task Force (USPSTF) argue in a recent issue of the Annals of Internal Medicine that maybe it’s time to cut the ties between the task force’s advice and insurance coverage.

But that seems more like a rhetorical point in a piece that takes aim at Mylan and its “blatant attempt to twist the notion of prevention to get first-dollar coverage” for its product.

Virginia A. Moyer, Michael LeFevre, and Ned Calonge sang the praises of the USPSTF in their Annals piece and say Americans deserve an independent scientific process for assessing preventive services. “If the only way to assure such independence is to sever direct linkage to coverage, then it may be time to consider the option,” they wrote.

Under the ACA, preventive services that receive an A or B recommendation from the USPSTF must be covered by insurers without a copayment by the beneficiary. The trio weighed the pros and cons of the requirement. On one hand, more Americans now have access to these now-covered preventive services. On the other hand, mandating coverage of preventive services may inadvertently keep people from getting other important care by contributing to the growing number of health plans with high deductibles and copays. “Parity in coverage of preventive and nonpreventive services should be expected,” wrote the former USPSTF leaders, “but preventive services cannot be assumed to be of greater value than other services.”

Interesting point. But their ire, though, is directed at Mylan, not the ACA or USPSTF. In September, the New York Times said that its reporting showed that Mylan was behind an orchestrated effort to get the epinephrine autoinjector classified as a preventive service.

Calling the EpiPen a preventive service is like calling an appendectomy a preventive service, they wrote. Preventive services, they noted, target asymptomatic people with the goals of preventing future suffering or extending life.

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