Cancer physicians are concerned that findings of a new study could further limit their ability to treat anemia in cancer patients and maintain effective chemotherapy regimens, according to a spokesman for the Association of Community Cancer Centers, a Washington-based advocacy group.
Published in todays issue of the Journal of the American Medical Association, the study reviewed 51 Phase 3 clinical trials of erythropoiesis-stimulating agents, or ESAs, which are used to treat chemotherapy-associated anemia, and found an increased, but statistically insignificant, risk of death resulting from deep-vein thrombosis.
Similar findings published in 2007 prompted the CMS to limit its coverage of the drug. Physicians and patients are bracing for additional cuts in light of the new findings, said Matt Farber, manager of provider economics and public policy at the Association of Community Cancer Centers.
I think weve seen this coming for a while, and the use of ESAs has already decreased substantially, Farber said.
The coverage cuts have prompted greater use of blood transfusions to treat chemotherapy-related anemia and have forced some severely anemic patients to switch to less-intense chemotherapy programs, noted Farber. Thats a concern, because it takes longer to administer transfusions, and its a drain on the blood supply. Farber said the JAMA study could prompt private payers to initiate cuts to ESA coverage more rapidly. I think theres a definite concern (among doctors) about the precedent this might be setting.
A Food and Drug Administration panel is expected to recommend further restrictions on ESA use during a March meeting, according to news reports. ESAs include drugs such as Aranesp, Epogen and Procrit. -- by Shawn Rhea
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