CAR-T In Medicare: Add-On Payments But No New Bundle Planned For 2019

CMS determines in final hospital inpatient rule that it will reimburse CAR-T drugs under an existing Medicare payment bundle supplemented by add-on payments.

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The Centers for Medicare and Medicaid Services has approved new technology add-on payments to supplement Medicare reimbursement for Novartis AG’s Kymriah (tisagenlecleucel) and Kite Pharma Inc.’s Yescarta (axicabtagene ciloleucel) in 2019.

The payments will be the same for both drugs, despite company arguments that they should be different, CMS explained in the Medicare hospital inpatient prospective payment system final rule, released Aug. 2. A proposed version of the rule was issued in April

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