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Medicare & Medicaid Ruling Poses Significant Threat to Radioimmunotherapy (RIT) Treatment
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| Copyright: | PR Newswire | | Source: | PR Newswire | | Wordcount: | 555 |
NEW YORK, Nov. 26 /PRNewswire-USNewswire/ -- The Lymphoma Research
Foundation (LRF) wrote to Michael Leavitt, Secretary of the U.S. Department of
Health & Human Services (HHS), requesting him to immediately review the 2008
hospital outpatient prospective payment system (HOPPS) for
radioimmunotherapies (RIT) issued by the Centers for Medicare & Medicaid
Services (CMS).
RIT is a cancer therapy that delivers radioactive molecules directly to
specific lymphoma cells to kill them. Bexxar (tositumomab) and Zevalin
(ibritumomab tiuxetan), the two approved RIT drugs, represent important
treatment options for individuals with non-Hodgkin lymphoma, including
patients who have undergone other treatments that are no longer providing
therapeutic benefit. For some of these patients, radioimmunotherapy may be
the only effective option available. LRF and other members of the cancer
advocacy community are very concerned that the 2008 reimbursement levels will
deny patients' access to this very important treatment option.
As Leonard Rosen, Chair of LRF's Public Advocacy Committee stated in the
letter to Secretary Leavitt, "It is our understanding that the 2008 payment
rates will be significantly less than the cost of acquisition, preparation,
and handling of radioimmunotherapies. If this payment situation is not
resolved, hospital outpatient departments will be unable to stock these
therapies, and this treatment option will be effectively eliminated for non-
Hodgkin lymphoma patients."
To rectify this situation, LRF offered Secretary Leavitt the following
recommendations:
-- The Centers for Medicare & Medicaid Services (CMS) should consider the radioimmunotherapy regimen a specified covered outpatient drug, or SCOD. In the Calendar Year 2008 rule, the agency improperly splits the radioimmunotherapy regimen into separate elements and considers the initial doses to be diagnostic rather than therapeutic doses. This is at odds with the Food and Drug Administration labeling of the products and with current practice. -- CMS should cover the cost of compounding radioimmunotherapies. Elimination of the compounding fee creates another obstacle to the willingness of institutions to make this therapy available to their patients, because these institutions find the payment inadequate to meet their costs. -- The agency should consider setting payment for radioimmunotherapies on the basis of 106 percent of average sales price (ASP) or a composite ambulatory payment classification (APC) that would reflect the entire cost of the radioimmunotherapy regimen.
The letter closed with the following message, "Mr. Secretary, this is a
matter of public health that demands your personal intervention. We fear that
these radioimmunotherapies will simply not be available for treatment of non-
Hodgkin lymphoma patients after the new year if the payment rates for these
products are not adjusted."
About the Lymphoma Research Foundation
The Lymphoma Research Foundation (LRF) is the nation's largest voluntary
health organization devoted exclusively to funding lymphoma research and
providing patients and health care professionals with critical information on
the disease. LRF's mission is to eradicate lymphoma and serve those touched by
this disease.
More than 85 cents of every dollar spent goes to research and programming.
As of the close of FY 2006, LRF has funded $34.7 million in lymphoma-specific
research. LRF also provides a comprehensive series of programs and services
for patients, survivors and loved ones affected by lymphoma, including our
toll-free Lymphoma Helpline and Clinical Trials Information Service, in-person
patient education programs, webcasts/teleconferences and support services.
For more information, visit www.lymphoma.org
SOURCE Lymphoma Research Foundation
CONTACT: Marion F. Swan, Lymphoma Research Foundation (LRF), +1-646-465-9126, or +1-347-920-6680, mswan@lymphoma.org
This is a news service of Thomson Business Intelligence Service ©2006. This content is for your personal use only, subject to Terms and Conditions. No redistribution allowed.
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