Straight Talk About Cancer Drug Coverage
This article was originally published in RPM Report
Executive Summary
CMS’ coverage of cancer drugs isn’t as automatic as you think. Here’s how the Medicare agency sees it.
You may also be interested in...
It’s Official: FDA Approval Does Not Equal CMS Coverage
Medicare’s updated coverage determination policy spells out in black-and-white that the payor agency does not feel that the law requires it to pay for FDA-approved products used on-label.
What Will CMS Do With Avastin In Breast Cancer?
With FDA’s decision to pull the indication for Avastin in breast cancer, CMS is now waiting and watching for residual use patterns.
What New Cancer Pathway Programs Mean For The Drug Industry
New efforts by US payors suggest oncologics no longer enjoy the same protected reimbursement status they once did, potentially pulling the rug from under biopharma's hottest development, dealmaking, and revenue generating activities. To succeed in an increasingly competitive marketplace, biopharmas must adapt their strategies with an eye to reducing payors' overall costs.