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Medicare Cuts Payout on 2 Cancer Drugs

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By ALEX BERENSON
Published: December 7, 2007

New Medicare rules for a small but promising class of cancer drugs may cause thousands of lymphoma patients to lose access to the treatment, which in some cases is the only therapy available to them.

The drugs’ makers and patient advocacy groups say the changes will sharply cut reimbursement for the medicines next year, and they predict that many hospitals will stop offering the treatments. The Medicare changes come just as new data provides additional evidence that the medicines, called Bexxar and Zevalin, are effective.

The drugs are given to treat non-Hodgkins lymphoma, the fifth-most-common cancer, and are usually prescribed for patients who have not responded to other therapies and who have few remaining treatment options. Clinical trial data show that they put the disease into remission for years in many of those patients.

Under the new rules, after Jan. 1, Medicare will reimburse hospitals about $16,000 for each treatment with the drugs, which a patient needs to receive only once. GlaxoSmithKline, which markets Bexxar, says it is priced at almost $30,000 a treatment, and Biogen Idec, which sells Zevalin, says it costs nearly as much. While high, such prices are not unusual for new cancer therapies, which can cost $50,000 or more for a year of treatment.

Senior Medicare officials say they are not trying to prevent hospitals from giving Bexxar and Zevalin. They say that $16,000 is a fair price and is based on the actual prices hospitals have paid for the medicines this year.



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