Neb-med providers get reprieve

Sunday, December 31, 2006

WASHINGTON - CMS initiated a review Dec. 20 on the use of levalbuterol in the treatment of COPD. The review will delay any possible reimbursement cuts for nebulizer medications for at least the first half of 2007.

The industry has been holding its collective breath for most of 2006, waiting for a final decision on a proposal to reimburse brand-name drugs Xopenex and DuoNeb at generic rates. Comments ended last May, and industry insiders had expected a final decision by the end of 2006.

Instead, the new review will supersede the original proposal.

Industry insiders say there's evidence supporting these drugs, but when it comes to newer and more expensive brand-name versions, CMS probably plans to look closer at whether they're medically necessary.

Joe Lewarski, vice president of clinical and government affairs for Inogen, said he wasn't surprised by the move.

"It's a high utilization and high expense area for Medicare," said Lewarski. "The outcome may or may not be favorable for particular drugs."

Average sales price figures for the first quarter of 2007 remained stable, with Xopenex up 9 cents to $3.48 and DuoNeb down 3 cents to $1.05. Other changes were minimal.

The public comment period ends Jan. 19.