Cancer Patients Brace for Medicare Changes
By MARK SHERMAN
The Associated Press
Thursday, March 4, 2004; 2:30 AM
WASHINGTON - Patients and doctors are bracing for major changes in the way the government pays for treating cancer, with concerns that patients will have to wait in long hospital lines to receive chemotherapy or will be denied expensive but effective new drugs.
Federal officials say they need not worry, that neither physicians nor patients will be shortchanged by a revised payment structure being established under the new Medicare law President Bush signed in December.
They also point to provisions that beginning in 2006 will cover a wide range of previously uncovered, expensive, oral cancer drugs. In the meantime, the government will devote at least $200 million to pay for some oral drugs this year and next.
"Without this law, there would be nothing," said Leslie Norwalk, acting deputy administrator of the federal agency that runs Medicare.
Some advocates say cancer patients cannot wait. They want the government to increase money for oral drugs now.
Norm Scherzer of Wayne, N.J., said his wife, Anita, was a few months from death when she began taking Gleevec more than three years ago for a rare stomach cancer.
"She had a needle biopsy the day before she started taking it," said Scherzer. "Ten days later, she had a biopsy in the exact same place. The tumor wasn't there."
The Scherzers did not have to pay tens of thousands of dollars for the drug only because they were part of a trial sponsored by its maker, Novartis Pharmaceuticals.
Off-label uses of cancer drugs - i.e., therapies other than those for which drugs have received approval from the Food and Drug Administration - is an area in which possible changes could have a significant effect on treatment.
Medicare has been considering whether to stop paying for off-label uses of some expensive drugs, both to cut costs for the government health care program and to address questions about the effectiveness of some treatments.
"You can survive cancer, but I'm not so sure you can survive the financial disaster," said Bobbi de Cordova-Hanks, 68, of Jacksonville, Fla., who has been treated for breast and thyroid cancer.
Doctors can legally prescribe drugs for any use, and patient advocates argue that restricting the use of some drugs could eliminate patients' best hope for treatment.
"Cost should in no way be a consideration. Once approved, (Medicare) should pay," said Ellen Stovall, president of the National Coalition for Cancer Survivorship.
Medicare's Norwalk said a decision on off-label uses of cancer drugs likely would await the confirmation of Mark McClellan, the FDA commissioner whom President Bush has nominated to oversee Medicare. McClellan is both a physician and an economist.
© 2004 The Associated Press