/Medicare proposes coverage for new, expensive cancer treatment

Medicare proposes coverage for new, expensive cancer treatment

Medicare proposes coverage for new, expensive cancer treatment

Medicare would pay for new, expensive cancer therapies under a proposal released Friday by the Trump administration.

The proposal would require that Medicare cover Food and Drug Administration–approved CAR T-cell therapies, which uses a patient’s own immune system to fight cancer. 

Medicare currently isn’t required to pay for it. 

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Under the proposal, individuals who use Medicare to pay for CAR T-cell therapy would have to be monitored for two years post-treatment to inform future payment policies.

“Today’s proposed coverage decision would improve access to this therapy while deepening CMS’s understanding of how patients in Medicare respond to it, so the agency can ensure that it is paying for CAR T-cell therapy for cases in which the benefits outweigh the risks,” said Seema Verma, administrator of the Centers for Medicare and Medicaid Services. 

The therapies are some of the most expensive on the market, with some costing hundreds of thousands of dollars.

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