Doctors urge CMS to change coverage rules for anemia drugs

September 4, 2007

Doctors treating cancer patients want CMS to ease rules restricting coverage of anemia drugs.

The American Society of Clinical Oncology has asked Medicare to ease rules that restrict the use of anemia drugs manufactured by Amgen and Johnson & Johnson, claiming the policy interferes with treatment of patients. In an Aug. 3 letter to CMS, the 23,000-member society said rules governing the coverage of anemia drugs limit doctors' "ability to provide the care they judge most appropriate for their patients." In July, CMS revised its coverage policy for Aranesp (darbepoetin alfa, Amgen) and Procrit (epoetin alfa, Ortho Biotech), ruling that Medicare will pay for the drugs only when a patient's hemoglobin count is at or below 10 gm/dl. Amgen has criticized CMS' coverage policy, saying it will increase the need for blood transfusions and compromise the quality of care. Within weeks of the CMS ruling, Amgen announced the layoffs of more than 2,000 workers; company executives blamed the cutbacks on declining sales of their anemia drugs.

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