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October 12, 2016

​Dr LeFevre

MU Physician Says Guidelines Should Inform – Not Determine – EpiPen Coverage

Michael LeFevre, MD, a professor of family and community medicine at MU, calls Mylan’s lobbying efforts "a blatant attempt to twist the notion of prevention to get first-dollar coverage and deflect legitimate concerns about the dramatic, and, as of now indefensible, increase in the cost of the device."

In September, the skyrocketing cost of the allergy treatment EpiPen made national headlines. Mylan, the maker of the EpiPen, is currently lobbying the U.S. Preventive Services Task Force to name the EpiPen a preventive drug.

Michael LeFevre, MD, a professor of family and community medicine at the University of Missouri and former chair of the preventive services task force, calls Mylan's lobbying efforts "a blatant attempt to twist the notion of prevention to get first-dollar coverage and deflect legitimate concerns about the dramatic, and, as of now indefensible, increase in the cost of the device."

The U.S. Preventive Services Task Force is an independent volunteer panel of 16 national experts in prevention and evidence-based medicine. Its mission is to improve the health of all Americans by making scientific recommendations on screening, counseling and preventive medications. Under the Affordable Care Act, insurers must cover the cost of any intervention that receives an "A" or "B" ranking from the task force without requiring a copayment. The panel does not consider cost or insurance coverage when making recommendations, only the scientific assessment of benefits and harms.

In an invited editorial published in the Annals of Internal Medicine published on Oct. 10,LeFevre, along with two other former chairs of the U.S. Preventive Task Force, said the EpiPen is not a preventive medicine.

"We doubt that Mylan will succeed with these current lobbying efforts, but it distracts from the mission and attempts to violate the integrity of the process," LeFevre said. "If the only way to assure independence of the U.S. Preventive Services Task Force is to sever its direct linkage to insurance coverage, then it may be time to consider that option."

In addition to LeFevre, the editorial was co-authored by Virginia Moyer, MD, vice president of maintenance of certification and quality of the American Board of Pediatrics, and Ned Calonge, MD, president and chief executive officer of The Colorado Trust.

LeFevre serves as the Future of Family Medicine Professor and vice chair of the Department of Family and Community Medicine at the MU School of Medicine. He served as chair of the U.S. Preventive Services Task Force from March 2014 until March 2015 and was a member from January 2005 until March 2015. During his tenure, the task force updated recommendations related to the frequency of breast cancer screenings, and the direct link between the task force and the Affordable Care Act was established.

The editorial is titled "Is It Time for the USPSTF to Inform - But Not Determine - Coverage?" To read it, visit www.annals.org or download the editorial.

*The views and opinions expressed in this "for expert comment" release are based on research and/or opinions of the researcher(s) and/or faculty member(s) and do not reflect the University's official stance.

Download a high-resolution photo of Michael LeFevre, MD.


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