A Closer Look: Decision For No Medicare NCD On ESAs In Renal Disease Would Be The Exception

Article preview from “The Pink Sheet”-   March 28, 2011

Many industry watchers were surprised when the Centers for Medicare and Medicaid Services conducted an extensive evidence analysis of ESAs, only to propose on March 16 no policy change. Indeed, the outcome, if made final, would be quite unusual, a look at numerous coverage analyses shows.

A Closer Look: Decision For No Medicare NCD On ESAs In Renal Disease Would Be The ExceptionArticle preview from “The Pink Sheet”-   March 28, 2011

Many industry watchers were surprised when the Centers for Medicare and Medicaid Services conducted an extensive evidence analysis of ESAs, only to propose on March 16 no policy change. Indeed, the outcome, if made final, would be quite unusual, a look at numerous coverage analyses shows.

Based on a review by “The Pink Sheet” of about 140 completed national coverage analyses posted on the CMS website, the agency most often sets new specific parameters for coverage in its final decisions. Most of the NCAs reviewed have been completed within the past 12 years.

CMS proposed March 16 that it will not issue a national coverage determination for erythropoiesis-stimulating agents in patients with chronic kidney disease because available data are too limited .

The draft decision followed a review process that involved two technology assessments and two meetings of the Medicare Evidence Development and Coverage Advisory Committee. The ESA proposal will be subject to a 30-day comment period before a final decision is released June 16, 2011.

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