Expansion of Medicare Coverage for Off-Label Cancer Drugs Drives Up Cost, NYT Editorial States
Since "the Obama administration seems ready to eliminate laws, policies or conflicts of interest that may be driving up costs unnecessarily," it should examine a November 2008 change in Medicare policy to expand coverage of drugs for off-label uses to treat cancer patients that "seems likely" to drive up costs, a New York Times editorial states. The new policy increased the number of reference guides, or compendiums, on which Medicare relies to determine which off-label uses to cover. According to the editorial, many experts say the "practical effect" of the new policy is to "virtually guarantee" that Medicare pays for most off-label uses. Although "[t]hat might be fine" if the compendiums were "authoritative and unbiased," they are "often supported by little clinical evidence and are written by experts with financial ties to the drug industry," according to the editorial.
The editorial continues that off-label uses for cancer drugs are "vitally important" and likely make up the majority of cancer treatments. However, "the danger in expanding usage without strong evidence of safety and effectiveness is that patients may be harmed -- and costs may be driven up unnecessarily," according to the editorial. The editorial concludes that the solution "is to establish centers for comparing the effectiveness of drugs and treatments and the cost-effectiveness of using them. That would help make coverage decisions more rational for all patients" (New York Times, 2/10).
