Medicare to pay for some cancer, other drugs

The U.S. government will pay for some cancer, multiple sclerosis and other medicines for 50,000 Medicare patients who otherwise would not have coverage until 2006, health officials said on Thursday.

Medicare will spend $500 million through 2005 on oral cancer drugs and other medications that elderly and disabled patients can take at home, Health and Human Services (HHS) Secretary Tommy Thompson said. Many of the medicines cost thousands of dollars a year.

“We are providing seniors and persons with disabilities suffering from some of the most debilitating diseases with some interim help in paying for their medicines,” Thompson said.

For example, Novartis AG’s cancer treatment Gleevec costs about $45,952 per year. Patients who receive assistance through the new Medicare project would pay $5,298, HHS said. Low-income patients would save even more.

Medicare is the federal health insurance program that covers 41 million elderly and disabled Americans.

Currently cancer patients and others receive Medicare drug coverage only for chemotherapy and other medicines administered in a doctor’s office.

Patient groups, including the American Cancer Society and The Seniors Coalition, lobbied for coverage of new oral, cancer-fighting medicines before full Medicare drug coverage starts in 2006. The program was mandated by the Medicare law enacted last year.

About $200 million will cover cancer care. The rest will pay for treatments for multiple sclerosis, rheumatoid arthritis, pulmonary hypertension and other serious, chronic ailments.

Some of the drugs include AstraZeneca Plc’s lung cancer pill Iressa, Actelion’s pulmonary hypertension therapy Tracleer and Amgen Inc.‘s Enbrel for rheumatoid arthritis.

Applications will be accepted through September 30, but more than 50,000 are expected, said Mark McClellan, who heads the agency that runs Medicare.

Participants would then be randomly selected, drawing equally from cancer and non-cancer patients, he said.

TrailBlazer Health Enterprises will oversee the application process and Caremark RX Inc. will administer actual benefits, McClellan said.

Some patient advocates have said many more people need financial help, particularly as prices for cancer drugs and other therapies soar.

In a letter to McClellan in April, American Cancer Society officials urged him to expand the benefit “as much as possible” to avoid possible “exclusions that will erode cancer coverage when (the full Medicare benefit) is implemented.”

(Additional reporting by Lisa Richwine in Washington, D.C.)

Provided by ArmMed Media
Revision date: June 22, 2011
Last revised: by Amalia K. Gagarina, M.S., R.D.