Bill Seeks Increased IVIG Pay
Legislation seeking to increase reimbursement for intravenous immunoglobulin (IVIG) has been introduced in the U.S. House of Representatives. Patient groups and IVIG manufacturers have said that Medicare's current coverage is so low that many physicians have stopped administering the therapy. A survey by the Immune Deficiency Foundation found that since January 2005, almost half of surveyed Medicare beneficiaries with primary immunodeficiency diseases had their treatments postponed by a physician, and 26% had serious health consequences because of the delays. The bill (H.R. 2914) would increase payment for IVIG and for ancillary services. It would also maintain the preadministration fee that physicians have been receiving and provide management fees for home IVIG infusion. H.R. 2914 was introduced by Rep. Kevin Brady (R-Tex.) and, as of press time, had 19 cosponsors, but no companion legislation in the Senate.
CMS Considers PET Coverage
Officials at the Centers for Medicare and Medicaid Services are considering whether to provide Medicare coverage for positron emission tomography (PET) for the diagnosis of chronic osteomyelitis, infections associated with hip arthroplasty, and fever of unknown origin. The agency opened its review of the issue at the end of June after receiving a national coverage decision request from Dr. Javad Parvizi, an orthopedic surgeon at Thomas Jefferson University, and Dr. Abass Alavi, a professor of radiology at the University of Pennsylvania, both in Philadelphia. A decision is expected in March. In a letter to CMS, Dr. Parvizi and Dr. Alavi argued that PET is more sensitive and specific for detecting infection and inflammation than are conventional imaging techniques. The combined use of PET and CT would allow physicians to determine the precise location of sites of infection and inflammation, they wrote. The request letter also included specific clinical criteria to limit overutilization.
Within Our Reach Grants
The American College of Rheumatology Research and Education Foundation recently awarded 15 grants to fund innovative research in rheumatology. The awards are the results of a new fundraising campaign that aims to raise $30 million to fund rheumatoid arthritis research that is not normally supported by the National Institutes of Health or other peer-reviewed funding sources. Since 2006, the “Within Our Reach” program has raised about $17.9 million from the pharmaceutical industry, biotech companies, physicians, and patients. The grants, which began in July, cover the areas of innovative basic research, translational research, and clinical practice. Each of the 15 recipients will be funded for 2 years at $200,000 per year. More information on the grant awards is available at
CMS Releases Medicaid Rule
CMS has unveiled a new method of setting limits on what the federal government will reimburse state Medicaid agencies for prescription drug payments. As part of the new regulation, states will be required to collect information from physicians about prescription drugs administered in their offices so that the state can collect any rebates offered by drug manufacturers on those products. The final rule will take effect Oct. 1. The regulation is expected to save states and the federal government $8.4 billion over the next 5 years. The change is in part a reaction to a series of reports showing that Medicaid payments to pharmacies for generic drugs were much higher than what pharmacies actually were paying for the drugs. Pharmacies, the reports showed, made the most profit on those generic drugs with the highest markup, creating an incentive to dispense those drugs.
Americans Buy Drugs Overseas
More than 5 million Americans adults, or more than 2% of the U.S. population, have recently purchased prescription drugs from another country, such as Canada or Mexico, according to a survey by the Pharmaceutical Research and Manufacturers of America. The vast majority of consumer importers said they were looking for the best price for medicines, but about half decided to buy their drugs in another country because they didn't have a physician's prescription for the drugs they wanted, the survey found. Importers were more likely to be younger than age 35 years, to be Hispanic, to live in a southern border state, and to spend more out-of-pocket money on prescription drugs than do nonimporters, PhRMA reported. Most of the drugs imported were to treat chronic ailments. PhRMA President and CEO Billy Tauzin said in a statement that importation increases a patient's risk of being exposed to “dangerous counterfeit medicines.”
HHS Expands Vaccine Capacity
The Department of Health and Human Services has awarded two contracts to expand the domestic influenza vaccine manufacturing capacity that could be used in the event of a potential influenza pandemic. The 5-year contracts were awarded to Sanofi Pasteur Inc. ($77.4 million) and MedImmune Inc. ($55.1 million). The contracts provide funding for the renovation of manufacturing facilities and for manufacturing operations for 2 years, with options for an additional 3 years of operations. Upon completion, these facilities will expand domestic pandemic vaccine manufacturing capacity by 16%, according to HHS. In addition, the facilities will expand vaccine availability for the national stockpile.