Magellan Reviews New Technologies
Magellan routinely reviews existing and emerging technologies to determine if sufficient evidence exists to approve them for use with our members. In 2009, the Magellan Technology Assessment Committee reviewed the use of four technologies:
- Virtual reality exposure therapy (VRET) for the treatment of post-traumatic stress disorder (PTSD) and phobia
- Social skills training for the treatment of autism
- Repetitive transcranial magnetic stimulation (rTMS)
- Deep brain stimulation in the treatment of treatment-resistant depression and treatment-resistant obsessive-compulsive disorder (OCD).
The committee concluded the following:
Virtual Reality Exposure Therapy
- At this time, VRET as a treatment for specific phobia, natural environment and situational types, is an established technique for use in exposure therapy.
- VRET is a procedure that has shown promising results in the treatment of PTSD for war combat veterans and in social phobia. But, it remains an investigational procedure until the results of large-scale randomized clinical trials are published.
- VRET as a treatment for PTSD in rape victims has not yet been explored in scientific research and, therefore, remains investigational at this time.
Social Skills Training for the Treatment of Autism
Social skills training used in the treatment of autism is considered investigational. Studies on the effectiveness of behavioral and developmental interventions for autism spectrum disorders should continue to make improvements in their design in order to meet accepted methodological standards for clinical research.
Repetitive Transcranial Magnetic Stimulation
Based on the available evidence and our criteria, rTMS for the treatment of refractory major depression remains investigational. Study findings appear promising but are inconsistent at present – although meta-analytic analyses report a moderate treatment effect.
Deep Brain Stimulation in the Treatment of Treatment-Resistant Depression and Treatment-Resistant Obsessive Compulsive Disorder
Deep brain stimulation as a treatment for both treatment-resistant depression and OCD is an investigational procedure in its early stages of study and, therefore, is not approved for these indications.
We will review the technologies found to be investigational again when further studies on their efficacy have been conducted.
Technology Assessment Process
By policy, Magellan conducts new technology assessments proactively and in response to requests from our care management centers or from our network practitioners. We do this through the following process, applying the same criteria in making each technology assessment decision.
- The process may be initiated as a result of a newly published scientific evidence-based advancement in the field of behavioral health care or a provider request. The chief medical officer prioritizes the ranking for assessment of new technologies when simultaneous requests for review are made.
- Assessment is conducted by the Technology Assessment Committee, which consists of appropriate behavioral health care practitioners. This group may include representatives of customer organizations and primary care practitioners, as appropriate.
If you have any comments or questions about Magellan’s technology assessment process, please contact the medical director at the regional Magellan Care Management Center that services the members in your care.