[gdpawel]

It's been difficult for the Medicare program to contol the substantial costs of cancer drugs. In a recent issue of the New England Journal of Medicine, an article by Dr. Peter Bach stated that the costs to Medicare of injectable cancer drugs given in doctors' offices increased from $3 billion in 1997 to $11 billion in 2004, an increase of 267% at a time when the costs for the entire Medicare program increased 47%.

It also states that there was a huge reduction in Medicare expenses that occurred when the off-label use of ESAs (drugs for anemia-related issues) was found to actually cause harm to patients. The drugs were proven to be over-used and the net result of the expose was that use of these drugs quickly dropped and the costs to Medicare dropped from over $1 billion a year to just $200 million.

In 2003, in the political payback deal of the century, Congress guaranteed premium pricing for pharmaceuticals, by prohibiting Medicare from negotiating drug prices, and it provided hundreds of billions of dollars in U.S. taxpayer subsidies to pay for these premium drug costs. Now the specter of "rationing" is raised.

Dr. Bach stated ways that the Medicare program could control costs. One of those ways was to fund a comparative-effectiveness program to assess whether or not treatments (mostly the newer targeted regimens) are really better than older treatments. Decisions are being made about what cancer treatments patients can actually afford.

Congress did not intend for the comparative effectiveness research funding included in the bill to be used to mandate coverage, reimbursement, or other policies for any public or private payer. The funding shall be used to conduct or support research to evaluate and compare the clinical outcomes, effectiveness, risk, and benefits of two or more medical treatments and services that address a particular medical condition.