Medicare Will Now Cover Transplant Procedure for Myelodysplastic Syndromes

Thursday, May 9th, 2024 -- 10:00 AM

(Hope Kirwan, Wisconsin Public Radio) Research by the Medical College of Wisconsin has helped change Medicare policy, allowing access to a transplant procedure for some cancer patients.

According to Hope Kirwan with the Wisconsin Public Radio, the Centers for Medicare and Medicaid Services announced in March they would cover allogeneic hematopoietic stem cell transplants for patients with myelodysplastic syndromes, or MDS.

The group of cancers causes a person’s bone marrow to produce an insufficient amount of healthy blood cells and are most common in older adults. The decision by CMS is based on nearly 14 years of research by the Medical College of Wisconsin’s Center for International Blood and Marrow Transplant Research, along with the American Society of Hematology and American Society for Transplantation and Cellular Therapy.

The organizations first petitioned Medicare to cover the transplant procedure for MDS patients in 2009, according to Dr. Douglas Rizzo, the center’s senior scientific director and a transplant doctor at the Medical College of Wisconsin.

Stem cell transplants have been used since the 1970s and studies had already shown the procedure to be the best treatment for MDS. But Rizzo said the federal agency found there wasn’t enough research proving the effectiveness of the treatment in people age 65 and older.

“However, if Medicare doesn’t cover allogeneic transplant, no coverage is sort of the same as no access,” he said. “So it was sort of a chicken or the egg argument.” He said the agency decided to allow coverage for Medicare recipients if they agreed to participate in a study that would inform their coverage policy, what’s known as coverage with evidence development.

It launched the two national studies supported by the Medical College of Wisconsin and researchers across the country.

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