Medicare Widens Drugs It Accepts for Cancer Care
Published: Tuesday, January 27, 2009 at 5:22 a.m. Last Modified: Tuesday, January 27, 2009 at 5:22 a.m. Medicare, with little public debate, has expanded its coverage of drugs for cancer treatments not approved ...
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Since: Dec 05
#1 Jan 27, 2009
In the setting of metastatic cancer, if you look at the NCI-recommended treatments, you'll find that all patients in this setting are candidates for clinical trials of some sort. This is just another way for the NCI to say that there is no single "best regimen" to give to the "average" cancer patient and it is therefore entirely appropriate to consider novel drugs or drug combinations for different types of cancers.
It has been very routine and well-accepted practice to prescribe drugs in cancer types and disease stages outside of those in which the drugs originally received FDA approval. Generally, however, insurance companies have paid for drugs used outside of FDA-approved settings because the treating physician finds their use in those instances to be "medically necessary."
Medicare has radically expanded its authorization for use of cancer drugs by putting off-label decision making in the hands of compendia writers in the private sector, many of whom are on the payrolls of the companies that make the drugs. An estimated 60 percent of anti-cancer drugs are used off-label.
I'm all for cancer patients, particularly at end-stages, receiving these needed drugs. My personal belief in having additional support of drug patient-specific activity, as determined by extensive laboratory pre-tests to improve patient outcomes, could very well bolster an argument for off-label use of specific cancer drugs, with no economic ties to outside healthcare organizations; recommendations made without financial or scientific prejudice.
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