NEW YORK, Jun 07 (Reuters Health) - The Health Care Financing Administration
(HCFA) has decided to expand Medicare coverage for patients with severe
rheumatoid arthritis. Medicare will now cover a blood processing therapy for
patients with rheumatoid arthritis who have not responded to conventional drug
therapies.
The decision was based on scientific evidence that the use of protein A
columns may benefit some patients. With an apheresis machine, a patient's plasma
is separated from blood cells, then passed through the protein A column and
rejoined with the blood cells for re-infusion. The mechanism for patient
improvement is unknown, but the column is known to bind and then remodel immune
complexes.
Although the agency's decision will benefit some patients, it "does not
affect the great number of Medicare beneficiaries with the disease who can and
do benefit from the disease-modifying anti-rheumatic drugs," HCFA noted in a
statement released Tuesday, because Medicare does not currently provide an
outpatient prescription drug benefit.
"Millions of people with arthritis do not have access to the medications
they need because Medicare does not include a prescription drug benefit," HCFA
Administrator Nancy-Ann DeParle said in the statement. "No one should be denied
such critically important healthcare treatment."
HCFA notes in the statement that "The Clinton administration has asked
Congress to enact an affordable, comprehensive, outpatient prescription drug
benefit available to all Medicare beneficiaries."
However, the decision to make the blood processing therapy available to
rheumatoid arthritis patients "is an example of HCFA's willingness to use our
new coverage process not only for items, services or procedures that affect a
large number of Medicare beneficiaries, but for those that may be of great
importance for only a few," DeParle stated.
Medicare has covered the protein A column treatment for patients with the
immune system disorder idiopathic thrombocytopenia purpura since 1991. The
treatment, marketed under the name Prosorba, is covered when other treatments
have failed.
