HEALTHAMA delegates vote for coverage of off-label drug useThe House of Medicine endorses various policies aimed at improving drug safety and patient access.By Victoria Stagg Elliott, amednews staff. July 12, 2004. Chicago -- Third-party payers, including Medicare, should be required to cover off-label uses of drugs that are supported by peer-reviewed literature, according to policy adopted by the American Medical Association at its Annual Meeting last month. The move came in reaction to reports that insurance companies were using Food and Drug Administration approvals to determine reimbursement -- despite the fact that off-label prescribing is legal and common. "We do this all the time," said AMA Trustee Kevin C. Reilly Sr., MD. "It's very proper, and we need to be able get reimbursement for ourselves and our patients when we do use medicines appropriately." The AMA also encouraged health plans to allow more choices in their formularies and called for protocols that would allow the use of non-formulary drugs, if the physician determines it appropriate. In addition, patients should not be switched to various drugs because of changes in the formulary, particularly if they are stable on one regimen. "We want everyone to be safe and at the same time [medicines to be] cost-effective, and a proper functioning formulary system can do that," said Michael S. Ellis, MD, an otolaryngologist and delegate from Chalmette, La. On the access side, the AMA will monitor drug patent issues to ensure that they do not interfere with the availability of cheaper alternatives. But the organization does not want to take away the financial incentive to develop new drugs that patent protection provides. [...]Full text of American Medical News content is available to AMA members and paid subscribers.
Copyright 2004 American Medical Association. All rights reserved.
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