Frank R. Lichtenberg left some important facts out of his Aug. 20 op-ed column, which criticized Medicare coverage and payment for cancer treatments.

The recent Medicare reform law requires reduced payments for drugs administered in physicians' offices so that those payments more closely reflect market prices. But Medicare is more than doubling the payments to physicians for administering those drugs, a fact that Mr. Lichtenberg didn't mention.

He is wrong to criticize Medicare for being too slow to begin paying for new treatments. Since Jan. 1, 1999, it has been paying for two of the new drugs Mr. Lichtenberg cited as examples -- capecitabine and temozolomide. The third, raloxifene hydrocholoride, has not been approved by the Food and Drug Administration as preventing breast cancer.

The administration has been trying to modernize Medicare to increase payments for preventive services and streamline access to state-of-the-art care.

As authorized by the Medicare reform law, Medicare is implementing a demonstration program to pay for oral drugs that replace drugs administered in physician offices. This demonstration, which includes 22 drugs used to treat a variety of serious illnesses, will involve 50,000 Medicare beneficiaries.


Deputy Administrator

Centers for Medicare

and Medicaid Services