Medicare Part B Coverage Expands to Include Merck's Emend

The Centers for Medicare & Medicaid Services (CMS) has expanded its coverage of Medicare Part B drugs to include Merck's oral, antinausea treatment Emend.

The coverage decision on Emend (aprepitant) is somewhat unique because Medicare Part B rarely covers drugs that are administered by the patient, such as oral medications. "This is a significant step in our ongoing efforts to provide the best cancer care for our beneficiaries," said CMS Administrator Mark McClellan.

The CMS first proposed Emend for coverage in January. Emend will be included for use with two other drugs for the prevention of nausea and vomiting when patients receive any specified chemotherapy treatments known as highly emetogenic chemotherapy, the CMS said. These chemotherapy treatments cause severe symptoms of nausea and vomiting in most patients who receive them.

The three-drug regimen includes Emend combined with two standard antiemetic drugs - a 5-HT3 antagonist and dexamethasone. The treatments are administered immediately before chemotherapy, with additional doses given afterwards. The addition of Emend will improve treatment for those patients who do not completely respond to the other drugs, the CMS said.

The Medicare Modernization Act provides Part B coverage for oral drugs used to treat chemotherapy-induced nausea and vomiting if the oral antiemetic drug functions as a replacement for the intravenous drugs that would have otherwise been administered. In this case, the combination of the three drugs will replace the intravenous drugs that would otherwise be necessary, the CMS said.