Senate urges CMS to reconsider decision on ESA coverage

September 10, 2007

Senate asks CMS to reconsider ESA coverage decision

The Senate is stepping into the fray over Medicare reimbursements for erythropoiesis-stimulating agents (ESAs). In a resolution unanimously passed on Sept. 4, the Senate asked CMS to reconsider its decision to restrict coverage of two popular anemia drugs, Aranesp (darbepoetin alfa, Amgen) and Procrit (epoetin alfa, Ortho Biotech). In July, CMS issued a final set of rules governing the use of ESAs in cancer patients; the rules require doctors to wait until hemoglobin levels drop below 10 gm/dl before starting anemia treatment with ESAs. The restriction has come under fire from several groups, including the American Society of Clinical Oncology and the Association of Community Cancer Centers. Both groups say CMS' restriction compromises the quality of cancer care doctors provide and increases the number of blood transfusions that would be necessary to treat cancer patients. In its resolution, the Senate urged CMS to reconsider its final coverage rules for ESAs and to consult with the clinical oncology community to determine "appropriate revisions." The resolution also says that 52 Senators and 235 members of the House of Representatives have written to CMS with their concerns about its ESA coverage rules.

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