Merck's Emend Granted Broad Coverage Under Medicare Part B
This article was originally published in The Pink Sheet Daily
The oral anti-emetic will be covered by Part B for first-line use in combination with dexamethasone and a 5-HT3 antagonist in patients receiving any of nine highly emetogenic chemotherapy agents under a final coverage decision memo. CMS loosens conditions for reimbursement in response to comments.
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The current Medicare Part B national coverage determination says use of the anti-nausea drug with highly emetogenic anti-cancer chemotherapy is reasonable and necessary; the National Comprehensive Cancer Network asks CMS to update the NCD based on evidence supporting use with moderately emetogenic agents.
The anti-emetic would be covered by Medicare Part B when used in combination with a 5-HT3 antagonist and dexamethasone in patients refractory to standard treatments, CMS says. Other uses of Emend would be covered under Part D beginning in 2006.
A possible settlement between Merck and tax authorities could be significantly smaller than GlaxoSmithKline's recent settlement with the IRS based on the companies' projected liability