Medicare Continues to Deny Reimbursement for Anemia Drugs

Agency cites heart attack, stroke risks as reason

09/25/07

On September 24, 2007, the United States Medicare agency announced without further evidence, it will continue to refuse reimbursement for anemia drugs such as Amgen’s Aranesp.

The decision was emphasized in a letter from the U.S. Centers for Medicare and Medicaid to physicians who attempted to change the agency’s position on the matter.

The agency offered 30 days for researchers to show proof of why it should change its stance, which is based on reviews of more than 800 publications and 2,600 comment letters.

Earlier this year, the government decided to no longer reimburse cancer patients for eryothropoiesis-stimulating agents (ESAs) such as Johnson & Johnson’s Procrit and Amgen’s Aranesp and Epogen after studies suggested the drug is linked to increased risks of stroke and heart attack.

ESAs are used to increase oxygen-carry hemoglobin in the blood to avoid blood transfusions and battle anemia. Normally, doctors would purchase the drugs from manufacturers and be reimbursed for patients on Medicare. Under the new rule, only patients being treated with chemotherapy whose blood hemoglobin levels drop below 10 grams per delimiter will be reimbursed.

Source: “Medicare Says Anemia Rule Likely to Stand,” WSJ.Com, September 25, 2007.

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