On Wednesday, the U.S. CMS (Centers for Medicare and Medicaid Services) has announced an exclusive decision. The company has decided to cover pricey cancer cell treatments marketed by Gilead Sciences Inc. and Novartis AG. CMS backs Medicare; it is the federal government’s health plan for people across the U.S. having age 65 and above. Medicare, a national health insurance program in the U.S., has announced it will cover the treatment approved by the U.S. FDA. A Trump government official noted they would make sure patients have compatible and likely access to a probably lifesaving treatment.
While announcing the decision, Administer of CMS Seema Verma noted, so far, Medicare’s regional administrators had agreed whether to include the cure. It had resulted in confusion. Verma said the treatment in question was CAR T-cell therapy. Currently, it costs $375,000, or up to $475,000 depending on the level of cancer. Even more, other costs like stay in a hospital might add thousands of dollars to the treatment cost. According to pharmaceuticals, CAR T-therapy is a special therapy which is given only once. Besides, it is a potential treatment for people who have left with no other alternative medicine. Despite being high-priced, it is not beneficial for all patients. Even more, CAR T-therapy is the latest treatment of cancer; it is unclear whether it offers durable treatment.
Verma said such expensive treatments stir up a concern on how the system is going to pay for this in the long run. Still, the agency aims to work closely with other agencies to watch results for Medicare patients gaining this innovative therapy in the future. Majority of lymphoma patients eligible for CAR-T treatment will probably get a cover by Medicare. The organization said it would also cover the CAR-Ts for all patients as far as CMS-approved medical guidelines suggest them. While the American Society of Hematology has welcomed the decision.