Last shot for Medicare coverage of radioimmunotherapy (RIT)

With the help of the good people at Patients Against Lymphoma, we've been following the ruling by Medicare that costs of radioimmunotherapeutics for lymphoma would now only be reimbursed at less than the acquisition cost (CMS-1392-FC). So ridiculous is this proposition that Newsweek's Jonathan Alter weighed in with an article, "How Washington is Nixing a Cancer Cure."

We've now learned that two senators are modifying the language of the bill coming up for approval by the Senate Finance Committee tomorrow (4 Dec). However, there seems to be misinformation spreading regarding the affordability and cost-effectiveness of RIT. Wherever these counterarguments are coming from, they are patently false.

The facts and sources are listed below the fold but at this point the best course of action is to quickly contact your senator with the message here. Of particular value is if your senator is a member of the Finance Committee (membership here). Your support will be greatly appreciated by lymphoma patients and their families who might otherwise be denied coverage for a proven, life-saving therapy.


Background and Facts from Patients Against Lymphoma

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Greetings,

Why are these reports on the cost of RIT compared to other treatments important to patients?

Answer: Each report answers the *false* perspective that the CMS ruling should stand because RIT is too costly - that it's an extravagance our society cannot afford.

1) First an article on Zevalin:

"Conclusion: 90Y-ibritumomab tiuxetan is not more expensive than other established treatments for relapsed or refractory indolent NHL."

2) Second a review article (PDF) showing cost effectivness of Zevalin of Rituxan monotherapy:
"cost per year in remission (€14 862 vs. €16 967) and in particular cost per disease-free year (€22 235 vs. €80 077) were clearly in favour of Zevalin" over Rituxan monotherapy.

3) An abstract reporting on cost effectiveness of Bexxar (BTR)
"Conclusion: Overall, a BTR (Bexxar) strategy has a favorable cost-effectiveness profile to alternative strategies including rituximab maintenance (RXM) in first, second, and third line NHL therapy. Results imply both a possible survival gain with early BTR use, and the cost-effectiveness of BTR. This modeling approach can aid in clinical decision making regarding the sequence and timing of therapy for patients with follicular NHL. "

Cost-effectiveness of tositumomab and iodine I-131 tositumomab (Bexxar therapeutic regimen (BTR)), in treatment of non- Hodgkin lymphoma (NHL).

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ACTION:

Please call and email your Senators, and Key Senators on Finance committee. There are forces working against our plea, so it's critical that misinformation about the cost of RIT be addressed and that RIT remains as a treatment option for lymphomas.

Contact Key senators: http://www.lymphomation.org/CMS-call.htm#contact
Look up your senators: http://www.senate.gov

Please answer the call for action. I can think of no greater threat to our survival than to let the CMS ruling stand.

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Thank you for helping get the word out on this!!!!

Turns out Ron Wyden (my Senator!) is on the healthcare subcommittee, so I have sent him email. Hope it helps.

Thanks so much for your support Bill. I see from your blog that things have been very busy lately so I greatly appreciate you taking time out to contact Sen. Wyden.