NoBlood

[June 02, 2008]

Study Shows Transfusions Increase After CMS Rule

(BioWorld Today Via Acquire Media NewsEdge) Blood transfusions doubled for patients with chemotherapy-induced anemia at one Georgia clinic after the government issued a policy that markedly restricted payments for anemia drugs used in cancer patients, researchers reported Sunday.

That policy, issued July 2007 by the Centers for Medicare & Medicaid Services (CMS), largely eliminated coverage for erythropoiesis-stimulating agents (ESAs) when patients with chemotherapy-induced anemia have hemoglobin concentrations above 10 g/dL. ESAs historically have been the largest prescription drug cost for Medicare under its Part B program. CMS's payment rule, known as the National Coverage Decision (NCD), does not affect use of ESAs in noncancer conditions, such as chronic renal disease. While Medicare covers the drugs to treat anemia caused by chemotherapy, it does not cover ESAs used to treat anemia caused by the cancer itself.

CMS opened a review of its payment policy on the use of ESAs in cancer and related neoplastic conditions in response to the FDA's March 2007 call for a black-box warning on the drugs. The black box has been expanded twice since with stronger warnings. (See BioWorld Today, March 12, 2007, Nov. 9, 2007, and March 11, 2008.)

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