Earlier this week, the Centers for Medicare and Medicaid Services (CMS) announced that it will limit Medicare coverage for anemia medications in cancer patients. CMS will cover medications to treat anemia caused by chemotherapy but won’t cover medications for anemia caused by cancer. (Kaiser Network)
Roger M. Perlmutter, a physician and spokesman for the drug company Amgen said, “The coverage restrictions placed on the FDA-approved indication have no scientific basis and are incompatible with good clinical practice…Moreover, through this coverage decision, the CMS has undermined the ability of physicians to decide how best to administer ESA therapy to their patients through carefully defined dosing guidance articulated by the FDA.”
In other Medicare news, CMS issued new rules last year that would allow denial of coverage through Medicare Part D for drugs prescribed for off-label uses, according to the Medical Rights Center.
Jeffrey Kelman, chief medical officer for Medicare’s Center for Beneficiary Choices, told USA Today that Medicare rules do allow patients to get prescriptions for off-label drugs, but the drugs must appear in drug reference guides as useful to their condition. “There has to be some reason for using (the drugs),†Kelman said.
