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To: NOW who wrote (52290)	2/1/2006 1:39:28 PM
From: GraceZ	Read Replies (1) \| Respond to of 110194

You should already know since you follow this sector. Here's one which has such narrow reimbursement that it is effectively dead: finance.yahoo.com Even therapies that don't get buried aren't used as much as they might be if they weren't hostage to reimbursement logjams in both the public and private spheres. finance.messages.yahoo.com Re: Administered my first Abraxane! by: wannabejesse 01/28/06 08:23 pm Msg: 82012 of 82056 For a Joe Oncologistlike me and other community based oncologist not administering the drug immediately after approval is not that unusual at all. It is strictly the reflection on the reimbursement process. Remember, I have to pay for the drug, then give it to the patient than pray on my knees it gets reimbursed, ha-ha. And you guys fret here over few thousands. Try a million dollar drug bill charge every month with uncertain outcome (Medicare or Commercial insurers decide to refuse payment). As for the drug rep for Abraxane- it is true that its weak and I have no idea why. That fact nothwistanding the rep for Abraxane is is in my office every other week and we laughed how I own the stock of the company that produces the drug that I wrote no prescription for yet. When you know the process it's not that surprising. For example, I have tons of MDS, Multiple myeloma as well CLL patients, and we all knew for several years that the drug is coming but have not prescribed Revlimid yet eventhough its been more than a month it was approved. Its just so happens. Doctors as everybody else are creature of habit and it takes time to brake their prescribing habits too. I think that people outside of oncology world put to much haste and credence just in approval moment. It takes time for the drug to filter down to the masses and gain its acceptance. Abraxane still has a narrow indication now, much like Taxol and Taxotere had it in early nineties and- look now- both drugs are ubiquitous. Basically, at this point you dont want to shell out $3500 of your own money only to learn that Medicare or HMO refused payment. Third party payers are going to drag their feet, of course, why would they rush to pay $3500 for Abraxane dose instead of $1500 for Taxotere or even less for Taxol dose just because Joe Oncologist prescribed it. There is going to be a red tape for a while. However, I cannot foresee the future in which third party payer is going force the patients to get more toxic and possibly less efficacious chemo just because they said so. WBJ