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Medicare News
Oncologists Criticize Proposal to Reduce Medicare
Pay for Anemia Medications
CMS is accepting public comments on the proposal
until June 13
June 8, 2007 - A number of physicians attending the
American Society of
Clinical Oncology annual meeting in Chicago this week
expressed concern that
CMS "has
gone too far" with its proposal to limit Medicare reimbursements for the
treatment of cancer patients with anemia medications manufactured by
Amgen
and
Johnson & Johnson,
Dow Jones reports.
CMS is accepting public comments on the proposal
until June 13 and is expected to issue a final decision by mid-September
(Loftus,
Dow
Jones, 6/5).
CMS last month announced the proposal, which states
that anemia medications will not be covered if used as treatment to
prevent anemia or if after four weeks there is evidence of "poor drug
response."
In addition, the proposal states the maximum length
of time that Medicare will reimburse for EPO drugs is 12 weeks per year,
and patients must have hemoglobin levels below nine grams per deciliter
of blood in order to receive Medicare coverage, among other provisions (Kaiser
Daily Health Policy Report, 5/15).
Charles Bennett, a professor at the
Northwestern
University Feinberg School of Medicine, on Sunday said that
the proposed changes "are Draconian and don't have patients' best
interests at heart, and seem financially motivated."
Bennett presented a new analysis at the meeting
indicating that drugs increase health risks, including the risk of blood
clots, only when prescribed for off-label uses. Physicians attending the
conference said that restricted use of the drugs would increase the need
for blood transfusions and potentially strain the nation's blood supply.
Some physicians also said that the proposal is not
based on clinical evidence. John Glaspy, a professor at the University
of California-Los Angeles
Geffen School of
Medicine, said at a symposium sponsored by Amgen at the
conference that physicians should address concerns among the public that
they are making a profit by over-prescribing anemia drugs.
"We have to address the public's concern, do some
soul-searching and make adjustments regarding conflicts of interest,
real or perceived," Glaspy said. Glaspy has received research and
consulting fees from Amgen. CMS officials could not be reached for
comment (Dow
Jones, 6/5).
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