US insurer limits payments on anaemia drugs from Amgen, Johnson & Johnson

A US nonprofit insurer decided to limit payments for Amgen's Aranesp (darbepoetin alfa) and Epogen (epoetin alfa), as well as Johnson & Johnson's Procrit (epoetin alfa), Bloomberg reports. A spokesman for the insurer, Blue Shield of California, stated that the new policy is based on "medical evidence only," adding that the potential cost savings are not known.

Blue Shield indicated that it will no longer pay for the anaemia treatments until haemoglobin levels decrease to less than 9 grams per decilitre in patients without heart disease, instead of the current level of 10 grams per decilitre. The insurer will also no longer reimburse the anaemia drugs for patients receiving certain cancer treatments, including Genentech's Avastin, or ImClone's and Bristol-Myers Squibb's Erbitux.

Amgen spokesperson Trish Hawkins responded that an "overwhelming majority" of healthcare professionals and patient advocates who have commented on a similar plan to limit payments for ESAs over safety concerns, proposed by Medicare in May, are opposed to such restrictions. Amgen believes reimbursement decisions should be based on "a comprehensive review of the evidence so that appropriate patients can continue to access these...medicines," Hawkins remarked.

As part of its plan, Blue Shield also indicated that Procrit would now be its preferred anaemia treatment, rather than Epogen, although it did not offer a reason for its decision. Johnson & Johnson spokesperson Stephanie Fagan stated that the company supports the insurer's "goal of ensuring that its coverage policies encourage appropriate use" of anaemia drugs.

The FDA recently strengthened the labels of ESAs over cardiovascular safety concerns.

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