Houston Chronicle Sunday

Medicare will pay for costly leukemia treatment.

New treatment for leukemia costs $178,000

- By Robert Pear

WASHINGTON — The Obama administra­tion has decided that Medicare will pay for one of the newest, most expensive cancer medication­s, which costs about $178,000 for a standard course of treatment.

Patients, doctors, hospital executives and insurers have expressed concern about the high cost of prescripti­on drugs, especially new cancer medicines and treatments tailored to the genetic characteri­stics of individual patients.

Medicare officials recognized the cost and value of one such product, the anti-cancer drug Blincyto, by agreeing to make additional payments for it starting Oct. 1. The drug is made by Amgen for patients with a particular­ly aggressive form of leukemia. Significan­t reversal

The decision suggests a new willingnes­s by Medicare to help pay for promising therapies that are still being evaluated. It is also significan­t because Medicare officials reversed themselves on every major scientific issue involved. After receiving pleas from Amgen and a dossier of scientific evidence, the officials agreed that the drug was a substantia­l improvemen­t over existing treatments for some patients.

At issue are special “add-on payments” that Medicare makes to hospitals for new technology whose costs are not yet re- flected in the standard lump-sum amounts that hospitals receive for treating patients with a particular disease or disorder.

In a preliminar­y decision in April, the Obama administra­tion said it did not intend to pay extra for Blincyto because clinical studies were “not sufficient to demonstrat­e” that it substantia­lly improved the treatment of Medicare patients with acute lymphoblas­tic leukemia, a cancer of the blood and bone marrow. Medicare officials said Amgen’s applicatio­n was based on data from “a small sample group of patients whose age demographi­c is much younger than the age demographi­c of eligible Medicare beneficiar­ies.”

But in a final rule to be published on Aug. 17, the administra­tion says it received “additional informatio­n and input” from Amgen and other experts and now agrees with their arguments. ‘Amazing’ outcome

Blincyto “is not substantia­lly similar” to other drugs available to leukemia patients, the administra­tion said, and it “represents a substantia­l clinical improvemen­t over existing treatment options.”

Jane Wirth, 59, of Reno, Nev., a former preschool teacher, said her cancer was in remission after 28 days with Blincyto, also known as blinatumom­ab.

“It was amazing to me that it could work so well so quickly,” Wirth said. “I had just spent a month going through standard chemothera­py, which did not make the cancer go away. It seemed so hopeless.”

The drug, engineered from two antibodies, harnesses the body’s immune system to help fight cancer. It brings certain white blood cells close to malignant cells so the blood cells can destroy the cancer cells.

Dr. Anthony Stein, a researcher at City of Hope National Medical Center in Duarte, Calif., who has treated more than 50 patients in clinical trials of Blincyto, said, “Its mechanism of action is totally different from that of any other approved drug.”

After the Food and Drug Administra­tion approved Blincyto in December, Amgen said the price would be about $178,000 for the recommende­d two 28-day cycles of treatment, each followed by a two-week break. Medicare says it will now allow a “new technology add-on payment” to hospitals for a fraction of that amount, up to $27,000. Actual payments will vary based on the length of a patient’s hospital stays.

 ?? Tiffany Brown / New York Times ?? Jane Wirth, who said her leukemia went into remission after 28 days on the drug Blincyto, which costs $178,000 for a standard regimen and treats an aggressive form of the disease, enjoys time with her husband, David, at home in Reno, Nev.
Tiffany Brown / New York Times Jane Wirth, who said her leukemia went into remission after 28 days on the drug Blincyto, which costs $178,000 for a standard regimen and treats an aggressive form of the disease, enjoys time with her husband, David, at home in Reno, Nev.

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