CMS Administrator Announces Proposals To Expand Medicare Coverage of Cancer Treatments
CMS Administrator Mark McClellan on Monday announced several proposals that would broaden Medicare's coverage of cancer treatments, the New York Times reports.
According to the Times, the "most significant" proposal would create a $300 million nationwide demonstration project designed to measure patients' reactions to chemotherapy. Medicare would reimburse oncologists $130 per beneficiary daily to collect information about pain, fatigue and nausea and vomiting.
The additional reimbursement would offset "much of the money" many oncologists said they lost last year as a result of the new Medicare law, which modifies the way they are paid, the Times reports. The doctors had said the Medicare law meant they were not paid "enough for the many things they did to enhance patients' quality of life," according to the Times.
On Monday, McClellan said that the proposal "is really about developing better evidence," adding, "We're not just giving doctors more money." Joseph Bailes, co-chair of the government relations committee for the American Society of Clinical Oncology, said the demonstration project is "an important recognition that the resources have to be there to care for individuals with cancer."
Under a second proposal announced on Monday, Medicare would cover four colon cancer drugs when they are used in any of nine clinical trials designed to test their effectiveness in treating other forms of cancer. The four drugs -- ImClone Systems' Erbitux, Genentech's Avastin, Pfizer's Captosar and Sanofi-Synthelabo's Eloxatin -- are approved only for treatment of colon cancer.
The National Cancer Institute-funded trials will involve 2,000 to 3,000 patients. The Times reports that Medicare's coverage of the drugs in the trials would have little effect on participants because most cancer patients who participate in clinical trials sponsored by NCI have their care paid for as a condition of joining the trial.
However, McClellan said Medicare's involvement would speed the trials and help determine "whether or not these treatments are beneficial" (Harris, New York Times, 11/2).
McClellan also announced on Monday that CMS has proposed covering positron emission tomography, or PET, scans to detect cervical cancer (Corbett Dooren, Dow Jones/Wall Street Journal, 11/2). McClellan said that the timing of the announcement is unrelated to the election, adding, "This is a set of steps to help develop better evidence on what works. We're way past any political influence here" (AP/Las Vegas Sun, 11/1).
The proposals are now subject to a 30-day period of public comment, and CMS will then have 60 days to make the changes final (Dow Jones/Wall Street Journal, 11/2).