Green Room

Berwick’s First Strike: Susan G. Komen Foundation and Ovarian Cancer Alliance Decry First-Ever Medicare Denials of FDA-Approved Cancer Drugs

posted at 6:09 pm on August 14, 2010 by

Just days after the recess appointment of Donald Berwick, the controversial new head of Medicare and Medicaid, the Ovarian Cancer National Alliance posted the following grim news: for the first time in history, an FDA-approved anti-cancer therapy may not be covered by Medicare.

Provenge, a vaccine to treat the recurrence of prostate cancer, has been approved by the Food and Drug Administration (FDA)… Medicare usually covers the cost of FDA-approved anti-cancer therapies. However, the Centers for Medicare and Medicaid Services (CMS) is still reviewing whether it will cover Provenge, and at what rate.

The CMS statute states that Medicare must cover therapies that are reasonable and necessary, while the FDA is instructed to approve drugs that are safe and effective. Because of the conflicting Federal coverage and approval requirements, there are some non-FDA approved drugs (called off-label drugs) that are paid for by CMS. However, with respect to Provenge, it appears that CMS is arguing that while the treatment is safe and effective, it may not be reasonable and necessary. For the first time, an FDA approved anti-cancer therapy may not be covered by Medicare.

A life-saving cancer treatment “may not be reasonable and necessary”? Gee, that kind of decision-making by an unelected federal bureaucracy certainly sounds like a death panel to me.

Say, I thought the President said that pre-existing conditions would always be covered. Isn’t cancer a pre-existing condition?

Oh. What’s this?

Susan G. Komen for the Cure and Ovarian Cancer National Alliance Appeal to FDA and Key Lawmakers on Avastin Issue

Patient Access and the Impact on Development of New Treatments at the Heart of Komen for the Cure’s Concerns

Susan G. Komen for the Cure® and the Ovarian Cancer National Alliance (OCNA) today urged the U.S. Food and Drug Administration (FDA) to continue to allow the use of the drug bevacizumab, commonly known as Avastin, for metastatic breast cancer patients, noting that it is effective for some patients and warning of a chilling effect on new drug development if approval is withdrawn…

…In a joint letter sent to the FDA and key Congressional lawmakers Thursday, Komen for the Cure and the OCNA wrote, “We are particularly concerned about patients who are presently receiving bevacizumab and the message that this decision sends about drug development for women with advanced breast cancer.”

…According to Komen, the decision to use Avastin should be made between a woman and her doctor after a thoughtful conversation that carefully considers the drug’s benefits and risks. Komen does not want to see access limited by Medicare and Medicaid.

Gee, and I thought no one would be denied coverage by ObamaCare.

Didn’t the President himself say, “I want seniors to know, despite what some have said, these reforms will not cut your guaranteed benefits.”

That’s what President Obama told us, endlessly and repeatedly, for months on end.

Do you mean to say he was lying?

Folks, this is precisely why the cancer survival rate for the U.K. is so much lower than that of the U.S. — and, in some cases, lower than Eastern Europe’s. And why Donald Berwick’s nickname is Dr. Death.

America’s seniors are about to find out that having coverage is not the same thing as receiving care. And our seniors are about to pay the piper.

Hat tips: Valerie Ward and Mark Levin. Cross-posted at: Doug Ross @ Journal.

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They should have just called ObamaCare Medicare/Medicaid Reform. Eventually everyone will be on one or the other due to ObamaCare. Repeal is the only hope.

txmomof6 on August 14, 2010 at 7:05 PM

Millions will die unnecessarily.

Millions.

notagool on August 14, 2010 at 7:24 PM

Death panels. Death by partisan bureaucrat.

ObamaCare: Repeal and Replace!

petefrt on August 14, 2010 at 7:45 PM

Palin was right. The “death panels” are already beginning.

Will the St Pete Times’ Politifact now retract their claim that Palin’s “Death Panels” was the 2009 Lie of the Year?

ornery_independent on August 14, 2010 at 8:50 PM

Maybe this is also Bammie’s plan for saving Social Security!

slickwillie2001 on August 14, 2010 at 9:26 PM

I’ll say it again – we let this happen, and waiting for the ballot box isn’t going to fix it.

It won’t matter how many folks that denied it before suddenly wake up, it won’t matter if Politifact retracts anything, etc – no amount of “we told you so” is going to fix this.

They knew they were lying.

We knew they were lying.

And we did nothing about it.

Will we now, or shall we just continue to piss and moan as our parents and then ourselves are denied life-saving care?

Midas on August 14, 2010 at 11:04 PM

Millions will die unnecessarily.

Millions.

notagool on August 14, 2010 at 7:24 PM

WRONG.

Millions must die by necessity. Remember, Obama is Bill Ayers, who is the Weather Underground.

In order for them to enact the societal transformation they envision, MILLIONS MUST DIE.

Inanemergencydial on August 14, 2010 at 11:40 PM

Midas on August 14, 2010 at 11:04 PM

Suggestions?

catmman on August 15, 2010 at 9:13 AM

Sounds like a death panel to me, too. We all knew it would be when a committee has the power to decide if treatment would be reasonable and necessary. Can we all admit now that Sarah was spot on.

Kissmygrits on August 15, 2010 at 9:31 AM

The move here is not to fight tooth and nail for ovarian cancer. That’s an almost irrelevant detail. The move is to repeal this monstrous health care takeover.

Why?

Because the normal course of events is utterly predictable:

Activist groups will protest and bully the government into covering ovarian cancer. Government will concede.

Next month, another disease will be slighted, and those activists will bully the government, etc.

Sooner or later, government will be forced to hold its ground. Yet government can’t alienate the voters it needs to retain power.

In short order, diseases will become associated with the Left and the Right political sides, based on demographics. (Hint: who gets prostate cancer, who gets herpes, who gets diabetes, etc.)

The conclusion? Democrats in power will deny life-saving treatment to certain diseases that are demographically more prevalent among conservatives, and they will guarantee treatment to diseases prevalent among the left.

We are one step away from the ovens. We just don’t know it yet.

jeff_from_mpls on August 15, 2010 at 10:13 AM

I wonder if Joe Leib’s wife is happy about his HCR vote. Seeing as she is on the board at the Komen Foundation?

kringeesmom on August 15, 2010 at 10:56 AM

Berwick: The new, improved Dr. Mengele.

Enjoy it, you facists. Your efforts to force a failed ideology onto us will soon be at an end.

BobMbx on August 15, 2010 at 1:57 PM