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Medicare expands coverage of off-label cancer treatments 

In a front-page story, the New York Times (1/27, A1, Abelson, Pollack) reports, "Medicare, with little public debate, has expanded its coverage of drugs for cancer treatments not approved by the Food and Drug Administration." In doing so, the Centers for Medicare and Medicaid Services (CMS) increased "the number of reference guides" that it "relies on for determining which off-label uses of cancer drugs to cover." Under the new rules, "adopted in the final months of the Bush administration," when "at least one of [the guides] recommends a cancer treatment, Medicare is essentially obliged to pay for it," even if "there is little clinical evidence behind a particular recommendation." Officials contend that the move is in response "to cancer doctors' concerns that the agency has been too slow to recognize promising new off-label treatments." The American Society of Clinical Oncology "hailed the new rules, saying they will ensure that the appropriate off-label uses are covered," and "drugmakers say they welcome the Medicare changes."

        However, critics of the new policies contend that the guides "could be influenced by their ties to the companies that make drugs," the Wall Street Journal (1/27, Armstrong) adds. According to experts, "two of the compendia are funded, in part, by pharmaceutical concerns and a third uses reviewers with financial relationships to drugmakers." One of the guides, "published by the National Comprehensive Cancer Network (NCCN), a group of hospitals, relies on panels of experts to review drugs." Half of the experts, however, "had financial ties with a cancer drugmakers." For its part, the NCCN stated that "it limits the potential for industry bias by disclosing the conflicts and making sure panels are large enough to prevent undue influence by a single voice."

 

 

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