Response from APA's Office of Healthcare Systems and Financing:

Drs. Barglow and Feinberg are correct in stating that APA has received money from Cyberonics, although we are not entirely sure what “four separate times” to which they are referring. Cyberonics has sponsored the APA newsletter Mental HealthWorks since its inception in 2002, and from 2002 to the present Cyberonics purchased product and symposia advertising in APA publications. Cyberonics has also purchased exhibit space and hosted symposia at APA annual meetings.

Members of the Council on Research were not asked to review the evidence on VNS presented to the FDA; they were asked only to determine whether, given that the FDA had approved the treatment, APA should recommend to CMS that Medicare consider VNS to be a reasonable and necessary treatment for a stringently defined subgroup of patients with treatment-resistant depression who had failed to respond to other treatments. Members of the council with conflicts of interest, including Dr. Nemeroff, recused themselves from this review. Discussions were conducted via e-mail.

Despite its name, APA's Medicare Advisory Corresponding Committee (MAC) is not a policy advisory body, but rather an ad hoc network of APA members who serve on their Medicare carriers' Carrier Advisory Committee. Consequently, members of the MAC were not asked to review this issue, nor would it have been appropriate to have them do so. Individual MAC members have discussed the issue of payment for VNS with their Medicare carriers.