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Cancer foundation urges CMS to cover cancer drugs

Case Management Weekly, February 17, 2004

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Several interest groups want the Centers for Medicare and Medicaid Services (CMS) to reimburse providers for off-label use of certain cancer medications, according to a statement from the Lorenzen Cancer Foundation (LCF) and the public interest law firm Washington Legal Foundation.

The two groups, and other advocates, asked CMS to reinstate a clear reimbursement policy for off-label use of the following drugs:

* Ibritumomab tiuxetan (Zevalin) and tositumomab (Bexxar) that are in use in treatment regimens for non-Hodgkin's lymphoma
* Oxaliplatin (Eloxatin) and irinotecan (Camptosar) that are in use in treatment regimens for colorectal cancer and pancreatic cancer

Despite federal legislation allowing off-label use, CMS began in 2002 to question the off-label use of a number of these newer and more expensive cancer drugs by placing them on coverage review. These actions, according to the LCF, created uncertainty about reimbursement and in some cases may have reduced the use of these medications at the patient's detriment.

For more information visit pancreatica.org.

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