Medicaid AMPs Should Be Limited To A-Rated Drugs – Pharmacy Lawsuit
Executive Summary
Medicaid's drug payment limits will be applied illegally to non-equivalent drugs under the program's average manufacturer price rules, the National Association of Chain Drug Stores and National Community Pharmacists Association argue in a lawsuit filed Nov. 7
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Medicare and Medicaid In Brief
Provenge review scheduled: The Medicare Evidence Development and Coverage Advisory Committee is scheduled to review Dendreon's novel prostate cancer vaccine Provenge (sipuleucil T) on Nov. 17. CMS says in an Aug. 31 announcement it has called the meeting to "consider the currently available evidence regarding the impact of labeled and unlabeled use of autologous cellular immunotherapy treatment on health outcomes." Provenge is approved for treating asymptomatic or minimally symptomatic prostate cancer that is metastatic and resistant to standard hormone treatment. The potential for use in earlier stages of the disease is the off-label opportunity. The review is part of a national coverage analysis for Provenge 1("The Pink Sheet," Aug. 9, 2010). The NCA recently prompted a letter from Sens. Arlen Specter, R-Penn. and John Kerry, D-Mass., who expressed concern about limiting access to Provenge among Medicare beneficiaries
Medicare and Medicaid In Brief
Provenge review scheduled: The Medicare Evidence Development and Coverage Advisory Committee is scheduled to review Dendreon's novel prostate cancer vaccine Provenge (sipuleucil T) on Nov. 17. CMS says in an Aug. 31 announcement it has called the meeting to "consider the currently available evidence regarding the impact of labeled and unlabeled use of autologous cellular immunotherapy treatment on health outcomes." Provenge is approved for treating asymptomatic or minimally symptomatic prostate cancer that is metastatic and resistant to standard hormone treatment. The potential for use in earlier stages of the disease is the off-label opportunity. The review is part of a national coverage analysis for Provenge 1("The Pink Sheet," Aug. 9, 2010). The NCA recently prompted a letter from Sens. Arlen Specter, R-Penn. and John Kerry, D-Mass., who expressed concern about limiting access to Provenge among Medicare beneficiaries
Medicaid holiday cheer for pharmacy
Medicaid's Internet publication of new average manufacturer prices and use of AMPs to set payment limits will be blocked temporarily, under a preliminary injunction granted Dec. 14. The U.S. District Court for D.C. will hear the suit against the AMP rules, filed by the National Community Pharmacists Association and National Association of Chain Drug Stores (1"The Pink Sheet" Nov. 12, 2007, p. 26)...