Bexxar, Zevalin face uncertain future come November

Patients with indolent forms of non-Hodgkin's lymphoma such as follicular lymphoma, the second most commonly diagnosed subtype, face losing one of the most effective treatment options available to them on November 1 when executives at the Centers for Medicare and Medicaid Services (CMS) meet.

CMS will determine how much, if any, they will reimburse hospitals which prescribe radioimmunotherapy (RIT), a treatment that combines a monoclonal antibody and a radioactive isotope to deliver radiation to specific cells in the body. RIT is available as both Bexxar and Zevalin. The latter includes the immunotherapeutic drug Rituxan, while the former does not. Both are effective in producing long-term remissions in patients, require much less time than chemotherapy or radiation, and produce fewer side effects.

Both treatments have been proven to be effective against indolent non-Hodgkin's tumors, yet neither has caught on and become a popular treatment choice for doctors, and patients generally know very little about them.

Because RIT requires a nuclear medicine department, and only certain centers are trained to deliver either Bexxar or Zevalin, the treatments have gone under-utilized. Another issue is the CMS' refusal to provide the kind of reimbursements to hospitals to make the treatments affordable options, even though both treatments are FDA approved for indolent NHL indications.

With private insurers following the lead established by CMS, RIT faces an uncertain future.