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Medicare Will Cover Costs For CAR T-cell Therapy In Cancer Treatment

Medicare which is run by the U.S. Center for Medicare and Medicaid Services has said that it would cover treatment costs for cancer, through CAR T-Cell therapy.

CAR T-cell therapy is a costly cancer treatment which ranges between $375,000 and $475,000, depending on the condition of the patient. This cell therapy is sold by Gilead Sciences Inc and Novartis AG (GILD.O and NOVN.S) which was approved in 2017 to cure particular kinds of leukemia and lymphoma.

As it is a high-priced treatment, cancer patients are happy that Medicare will cover the costs for the therapy. The Trump administration is making it easy for patients to receive consistent CAR T-cell treatment, which is considered a life-saving therapy.

Seema Verma, the administrator of the Center for Medicare and Medicaid Services has made the announcement about the cost coverage during a conference call when she spoke to reporters on Wednesday. She has added more clarity towards the coverage available to patients through the therapy. She says that “the decision will clear up a lot of confusion to patients who require coverage for CAR-T.

The agency had increased the maximum payment for CAR-T therapy. They will cover 65 percent of the cost of the therapy, which has been raised from the previous payment of 50 percent. In particular cases, patients will be eligible for supplemental payments too.

CAR-T is a novel treatment that helps patients to re-engineer their own immune system cells to fight their cancer cells. It has been able to cure 40 percent of patients for at least two years, says a study. But the treatment is expensive.

Verma says these expensive treatments will, however, strain the agency’s already vulnerable financial situation. “It is something we are extremely concerned about”, she adds.

The coverage that has been proposed on Wednesday was different from an earlier proposal which required collecting patient’s outcome data from hospitals.