WellPoint likely to follow FDA on anemia drugs
By Kim Dixon
WASHINGTON, April 21 (Reuters) - WellPoint Inc (WLP.N), the biggest U.S. health plan, will likely follow the lead of U.S. regulators, who are moving toward restricting the use of widely used anemia drugs sold by Amgen Inc (AMGN.O) and Johnson & Johnson (JNJ.N), a WellPoint official said on Monday.
In March a Food and Drug Administration panel recommended sharply restricting use of the drugs to patients whose cancers are not potentially curable, or who are not undergoing treatment.
The panel also recommended against use of the drugs in patients with advanced breast cancer or head and neck cancer. The agency typically takes the advice of its panels.
If the FDA followed that advice, WellPoint would mostly likely follow suit and restrict its coverage policy for the drugs, Sam Nussbaum, the chief medical officer of WellPoint, told Reuters.
"That is where we are heading," Nussbaum said. WellPoint's health plans cover about one in every 10 Americans.
Tens of thousands of cancer patients now take the drugs for anemia caused by chemotherapy. Their safety has been under a cloud for more than a year after eight studies found evidence of tumor growth or shorter survival for some patients given high doses of the drugs.
Despite tighter reimbursement for the drugs from the government's Medicare program for the elderly, insurers had taken a less-restrictive position on paying for the drugs.
Nussbaum cited internal WellPoint data finding that as many as 25 percent of its patients were getting the wrong type of dosing for the drugs, in most cases too much.
He acknowledged there will be much scientific discussion before WellPoint's final decision, given opposition from cancer doctors to Medicare's payment policy.
"There is this difference of opinion and it's pretty significant," he said.
A panel of outside independent experts meeting quarterly will make a recommendation to WellPoint about coverage decisions; a second internal panel sets final policies.
Total sales of Amgen's Aranesp sales fell 12 percent last year to $3.6 billion. About $1.5 billion of the total came from U.S. cancer-related sales. Sales of J&J's Procrit slid 9 percent to $2.9 billion.
The drugs, known as erythropoiesis-stimulating agents (ESAs), are genetically engineered forms of a protein that boosts production of red blood cells. The injectable medicines also are sold for patients with kidney disease. (Editing by Gerald E. McCormick)
