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Medicare Part B pays for an all-oral three-drug anti-sickness regimen, aprepitant with a 5-HT3 blocker and dexamethasone, for people receiving one of 20 listed chemotherapy drugs. It does not pay for aprepitant on its own.
United States, Medicare National Coverage Determination 110.18, version 2, effective for services on or after 29 May 2013, implemented 7 July 2014. CMS defines highly and moderately emetogenic chemotherapy as agents so designated in at least two of three guidelines (NCCN, ASCO, ESMO/MASCC). The oral three-drug regimen of aprepitant, an oral 5-HT3 antagonist and oral dexamethasone is covered for beneficiaries receiving, alone or in combination, alemtuzumab, azacitidine, bendamustine, carboplatin, carmustine, cisplatin, clofarabine, cyclophosphamide, cytarabine, dacarbazine, daunorubicin, doxorubicin, epirubicin, idarubicin, ifosfamide, irinotecan, lomustine, mechlorethamine, oxaliplatin or streptozocin, and "must be administered immediately before and within 48 hours after" the chemotherapy. From April 2005 to May 2013 the list had nine agents.
Not covered under Part B: aprepitant alone, and regimens given partly by mouth and partly intravenously. Contractors may decide on other all-oral three-drug regimens using aprepitant or another FDA-approved oral NK-1 antagonist, with the listed agents or any other highly or moderately emetogenic chemotherapy.
Showing the molecule this term concerns: Aprepitant (and fosaprepitant).
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