Your Voice Counts!

In my last entry, I explained that CMS (Center for Medicare and Medicaid Services) is proposing to cut reimbursement for Bexxar and Zevalin by approximately half and that, if approved, this would have dire consequences for lymphoma patients. I think we all agree that we simply cannot afford to lose this or any other valuable treatment option, and we need to let CMS know that the proposed change is unacceptable. Here’s how you can help:

CMS invites public comments, but the comment period will end September 14. Following is the letter I posted last week which you may change to fit your own situation. Instructions for posting comments follows the letter.

RE: CMS-1392-P
Comments regarding proposed changes to diagnostic and therapeutic
radiopharmaceuticals

Gentlemen:

I am writing to vehemently protest the proposed changes in reimbursement for I-131 tositumomab, commonly known as Bexxar, and Y90 ibritumomab, commonly known as Zevalin. These two drugs belong to a class of medicine known as radioimmunotherapy (RIT). Although the drugs are given as a single treatment, the proposed reimbursement separates their components for payment under both diagnostic and therapeutic radiopharmaceuticals. The total amount of reimbursement for all components of the treatment amounts to approximately one half their cost, leaving hospitals unreimbursed for the remaining cost. This will have dire consequences for patients, for it will effectively deny them access to these drugs.

Five years ago, I was rescued by RIT after all else failed, and so from a very personal standpoint, I know how effective it is. But more important than my personal experience, scientific studies consistently show that RIT is the most effective single agent available for the treatment of some forms of lymphoma. It has few side effects, and because it is given in a period of only one week, patients are able to return to work almost immediately. Traditional treatments such as chemotherapy and transplants require much longer treatment periods and cause significantly more side effects which add to both the cost of treatment and the reduction in patient productivity. Worse, these traditional treatments are known to be less effective than RIT.

If the proposed reimbursement change is adopted, hospitals will not subsidize this treatment and patients will no longer have access to it. In fact, if it is approved, the change will effectively sound the death knoll for this important and effective treatment. This begs several questions: How can the war on cancer ever be won if newer and better FDA-approved treatments are allowed to disappear because the system of reimbursement fails to recognize their value to human life? How many millions of dollars will have been wasted on their development? And how many patients will die?

It is highly doubtful that I would be alive today had RIT not become available in the nick of time. All patients deserve the same chance of a successful outcome, but they will not have that chance if the proposed change is adopted. And so it is that I urge you – in fact, I beg you – to consider patients first and to deny the proposed changes in reimbursement to these drugs. Thank you for your consideration.

Sincerely,

Betsy de Parry
Ann Arbor, Michigan

To post your comment, go to: http://www.accessdata.fda.gov/scripts/oc/dockets/comments/commentdocket.cfm?AGENCY=CMS On the left, click on CMS-1392-P and then click "Go" on the right. That will take you to a page where you will fill out your name and category (which is individual). Then click continue and that will take you to a page where you must select the "issue area." Scroll down and you will see a choice of "Payment for Diagnostic Radiopharmaceuticals" or "Payment of Therapeutic Pharmaceuticals." (Now we have a problem - CMS has divided payment for RIT into both of these categories, but because the therapeutic dose is the greater amount, I clicked that but referred to this problem in the letter above.) Once you have chosen the issue area, it will take you to the next page where you can post comments.

There is strength in numbers and so I urge you to join this grassroots effort. And if you need additional information, please don’t hesitate to contact me.

Many thanks,
Betsy