Expert Available For Comment: CMS To Cover Injections For HIV-Associated Facial Lipoatrophy
March 30, 2010 - In a landmark decision, the Centers for Medicare & Medicaid Services (CMS) has announced it will now cover the use
of FDA-approved dermal fillers for the treatment of HIV-associated facial lipoatrophy (LA), severely hollowed cheeks and changes to the face's appearance
resulting from HIV treatments. Specifically, CMS will cover the use of dermal fillers for Medicare beneficiaries who experience symptoms of depression
from the drastic change in their appearance that can lead them to discontinue treatments.
The American Society for Dermatologic Surgery Association (ASDSA), the advocacy
arm of the American Society for Dermatologic Surgery (ASDS), celebrated the ruling after advocating for coverage for more than a year. The ASDSA
believes the decision will be an essential step to ensure affected patients receive the treatment they need to improve their quality of life
and continue their therapies.
"Facial lipoatrophy can cause HIV-infected patients to look severely ill and experience such negative self images that they stop
taking their antiretroviral treatments," said Alastair Carruthers, FRCPC, a past president of the ASDS who played a critical role in making the case to
CMS. "FDA-approved injections can fill out the face's appearance so patients comply with their treatment regimens and are not jeopardizing their
health. We wanted to show that reconstructive treatments should be considered medically necessary and covered by Medicare, particularly given
that coverage of breast reconstruction following a mastectomy accounts for similar psychological effects and quality of life issues."
In making its decision, CMS referenced several articles from the ASDS' Journal Dermatologic Surgery. No other single publication
was cited as frequently. Dermatologic Surgery articles mentioned included the following:"ASDS Guidelines of Care: Injectable Fillers"
(A. Alam, H. Gladstone, E. Kramer, et al.)
"Evaluation of Injectable Calcium Hydroxylapatite for the Treatment of Facial Lipoatrophy Associated with Human Immunodeficiency Virus" (A. Carruthers, J. Carruthers)
"HIV-Associated Facial Lipoatrophy" (A. Carruthers, J. Carruthers, J. James)
"Retreatment with Injectable Poly-l-lactic Acid for HIV-associated Facial Lipoatrophy: 24-Month Extension of the Blue Pacific Study" (GM Humble, DR Mest)
"Reproduced with permission - ASDS - American Society for Dermatologic Surgery"
ASDS - American Society for Dermatologic Surgery