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November 20, 1991

Recombinant Erythropoietin and Medicare Payment

JAMA. 1991;266(19):2705-2706. doi:10.1001/jama.1991.03470190053026

To the Editor.  —The article by Sisk et al1 provided an informative account of the Medicare experience to date in coverage of erythropoietin. The conclusions, however, seemed unduly critical of the role of the Health Care Financing Administration (HCFA) in (1) the initial pricing of this drug; (2) the dosage levels given; and (3) the monitoring of its use.Erythropoietin was approved for use by the Food and Drug Administration in June 1989. In anticipation of this approval, the HCFA staff had been working for a year prior to this to develop a payment policy that would provide access to erythropoietin. Consequently, the payment regulation policy was implemented almost simultaneously with approval by the Food and Drug Administration. The payment rate was subject to considerable debate during this time. Input was received from Amgen Inc (Thousand Oaks, Calif), nephrologists, the Office of Inspector General, and Congress. The payment rate