Wednesday, October 28, 2009

The Wall Street Journal "Health Blog" reported that the Centers for Medicare & Medicaid Services (CMS) appears late yesterday to have changed its mind about reimbursement for small amounts of Avastin [bevacizumab], which physicians use to treat patients with age-related macular degeneration (AMD).


Avastin, which is similar to Lucentis [ranibizumab], is used off-label to manage AMD, but unlike Lucentis, which costs approximately $2,000 per injection, Avastin costs only about $30 per injection, making it considerably cheaper. Late yesterday, however, CMS announced without explanation that as of Jan. 1, it will reverse its Oct. 1 decision to reimburse Avastin at approximately $7 per dose, and will return to its previous higher reimbursement for the drug.


MedPage Today explained that even after CMS lowered its reimbursement for Avastin on Oct. 1, "reimbursement for Lucentis...remained unchanged at a whopping $2,039," thereby creating "a disincentive for using a drug that has been estimated to save Medicare $1.5 billion each year in treating macular degeneration alone.
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