Maker of 3-D Mammography Device Lobbies for Medicare Coverage

September 10, 2012 — Hologic, a leading manufacturer of a three-dimensional mammography device, this fall will launch a campaign to urge Medicare and private insurers to cover the device's use in breast cancer screening, CQ HealthBeat reports.

The new technology has the support of Sen. Richard Blumenthal (D-Conn.), who visited a Hologic manufacturing site in his home state last month. Blumenthal "will explore all options to support the important advances made in 3-D mammography technology with his colleagues on the Senate Finance Committee -- the committee that has jurisdiction over the Medicare program," a staff member said.

FDA in February 2011 approved Hologic's 3-D system to be used with conventional mammograms, which produce two-dimensional images. Hologic's system moves an X-ray in an arc over the breast to more clearly reveal tumors than conventional mammograms, which sometimes produces shadowy images that can mask tumors or raise suspicions that later prove unfounded.

About 10% of women who receive conventional mammograms are called back for additional screening of suspected abnormalities that turn out to be non-cancerous, resulting in unnecessary testing, costs and anxiety, according to CQ HealthBeat. A 2009 University of Pittsburgh study found that 30% fewer patients were called back when 3-D imaging was used.

Hologic's Campaign

The 3-D system is more costly for radiology and breast cancer clinics. Many private insurers consider the technology experimental, meaning that insured patients can pay up to $50 out of pocket if they want a screening.

Hologic's campaign will present additional clinical data and peer-reviewed papers to bolster its case that 3-D screening is effective and would save money for Medicare and private insurers because there would be fewer follow ups.

Meg Eckenroad, vice president of women's health at Hologic, said the company will seek a specific medical billing code that physicians and insurers can use to designate the screening as a standard medical procedure. The company also will approach individual private insurers and local Medicare contractors to advocate for coverage in their jurisdictions. Eckenroad estimated the process to get the device covered could take 18 months to five years (Norman, CQ HealthBeat, 9/7).