Biotechnology and Medicare's new technology policy: lessons from three case studies.
Biotechnology has figured prominently in recent Medicare coverage and payment policies. Biotech treatments push policy boundaries for several reasons: They attract strong patient demand; they often treat rare or life-threatening diseases; they may have uncertain evidence of health benefits; and they are often costly. This paper considers case studies of Medicare coverage for off-label uses of biotech cancer drugs and payments for anemia biopharmaceuticals. The cases suggest Medicare's ongoing challenge to balance access considerations, the role and strength of evidence, and cost consequences of new treatments.
Keenan
Patricia Seliger
PS
Division of Health Policy and Administration, Department of Epidemiology and Public Health, Yale University School of Medicine in New Haven, Connecticut, USA. patricia.keenan@yale.edu
Neumann
Peter J
PJ
Phillips
Kathryn A
KA
D000740:Anemia / Q000188:drug therapy* / Q000191:economics; D001702:Biopharmaceutics / Q000191:economics*; D001709:Biotechnology / Q000191:economics*; D019317:Evidence-Based Medicine; D006291:Health Policy; D006297:Health Services Accessibility; D006801:Humans; D006278:Medicare; D009369:Neoplasms / Q000188:drug therapy* / Q000191:economics; D019982:Organizational Case Studies; D014481:United States