If approved, the increased reimbursements for CAR T-cell therapy and “breakthrough” devices would go into effect on Oct. 1.
Centers for Medicare and Medicaid Services Administrator Seema Verma wants to boost reimbursements for certain medical innovations. By Laurie McGinley Laurie McGinley Reporter covering health and medicine Email Bio Follow April 23 at 7:19 PM Medicare officials on Tuesday proposed increasing reimbursements for a groundbreaking but costly cancer therapy used for patients whose blood cancers don’t respond to other treatments.
The list prices for the drugs are $373,000 or $475,000, depending on the illness for which they are used. Accompanying hospital care can double or triple the expense, especially for a patient with severe side effects who ends up in the intensive care unit, health providers say. Yet Medicare reimburses only a portion of that overall cost.
The Food and Drug Administration has approved two versions of CAR T-cell therapy — Kymriah, made by Novartis, for childhood leukemia and lymphoma, and Yescarta, manufactured by Gilead Sciences, for lymphoma. The treatments are approved for patients who have not responded to other therapies and have no other options.
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