Late last week, the Medicare contractor that provides coverage for several states unexpectedly posted a notice on its web site that it would no longer pay for Roche's Avastin medication for treating breast cancer after January 29. But late Friday, Palmetto, which is a subsidiary of BlueCross BlueShield of South Carolina, did an embarassing about face and rescinded its decision (read this).
The move came after the FDA last month began the process of removing the breast cancer indication for the medication following a review that found clinical studies indicated Avastin does not prolong overall survival in breast cancer patients or provide a sufficient benefit in slowing disease progression to outweigh significant risks. At the same time, there were serious side effects (see here).
The Medicare contractor, which also provides coverage in Ohio, West Virginia, Nevada, California and Hawaii, apparently acted too hastily, however. Sources say Palmetto did not go through the usual motions before posting its decision, which was quickly scrubbed from its web site, and allow for public comment. And its action annoyed officials at the Centers for Medicare & Medicaid Services, since Roche's Genentech unit is appealing the decision by the FDA, which assured patients that Medicare would continue to cover Avastin while the appeals process played out.