Groups Ask Congress Not To Intervene In CMS Decision On Anemia Drugs

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Cancer / Oncology
Article Date: 19 Oct 2007 - 7:00 PDT

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A coalition of consumer groups led by the Center for Science in the Public Interest and Consumers Union on Tuesday in a letter asked Congress not to intervene in a recent decision by CMS that will limit Medicare coverage for use of anemia medications -- Aranesp, manufactured by Amgen, and Procrit, manufactured by Johnson & Johnson -- in cancer patients, The Hill reports (Young, The Hill, 10/18).

According to a 61-page "national coverage determination" announced in July, Medicare will cover the medications, synthetic forms of the protein erythropoietin, to treat anemia caused by chemotherapy but not anemia caused by cancer. Under the decision, Medicare will cover the medications to treat anemia in cancer patients whose hemoglobin levels decrease to less than 10 grams per deciliter of blood. The decision will allow local Medicare contractors to determine whether to cover the medications to treat patients with myelodysplastic syndrome, a condition that can lead to leukemia (Kaiser Daily Health Policy Report, 10/17).

Last month, Reps. Anna Eshoo (D-Calif.) and Mike Rogers (R-Mich.) introduced a Congressional Review Act joint resolution (HJ Res 54) that would require CMS to reverse the decision. Amgen, J&J, the American Society of Clinical Oncology, the American Society of Hematology, patient advocacy groups, and for-profit cancer and kidney dialysis centers support the legislation.

Letter Details
In the letter, the coalition -- which includes the National Research Center for Women and Families, the National Women's Health Network, the TMJ Association and the U.S. Public Interest Research Group -- wrote, "Congress should set broad policy objectives and standards for Medicare, but congressional intervention regarding coverage policies for specific medical products would set a terrible precedent" (The Hill, 10/18).

The letter added, "It would encourage companies making medical products as well as medical specialty organizations to constantly ask members of Congress to override scientific evidence and spend taxpayer dollars needlessly on products whose sale would benefit those companies or specialties more than they benefit patients" (Edney, CongressDaily, 10/18).

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