Well according to MAC guidelines, clinical evidence isn't exactly the only thing they can consider. Societal/patient input, support by doctors and industry bodies must also be considered. MIGS has a lot of support from industry bodies, doctors and society. I think the route companies are taking is more related to the fact that the LCD goes against the guidelines of the MACs in relation to LCDs, in addition to presenting any evidence that was not considered in the original LCD. There are clearly many different flaws in relation to this LCD though, so it should be too difficult for it to be successfully appealed
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