tci Part B Insider - 2003 Issue 33

Off-Label Drugs: Medicare May Cover Unlisted Uses, But Expect to Back Them Up

Drug compendia, studies and documentation all may help gain paymentIf your physician is prescribing drugs for uses that aren't approved by the Food & Drug Administration, you could be filling a prescription for hassles. The most common off-label prescriptions are for oncology drugs. A chemotherapy drug "might be tested for lung cancer, but you try it on a prostate cancer," says attorney David Glaser with Fredrickson & Byron in Minneapolis. "If it's an off-label use, one question that comes up is the extent to which it can be covered under programs like Medicare," says attorney...

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