Edward Eisenberg This is Me

Education

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1. 1. dailypharmacist.com

   dailypharmacist.com/wordpress/ - [Cached]

   Published on: 4/1/2007   Last Visited: 4/15/2007

   In an interview with Psychiatric News, Edward Eisenberg, M.D., chief medical officer for Medco's Medicare business, said companies have had two sources of information for determining appropriateness of drug coverageâ€"FDA guidelines and four drug compendiaâ€"which have sometimes been in conflict. In the absence of clear guidance from CMS, Medco assumed that drugs prescribed at doses higher than approved by the FDA were not covered under Part D.
   
   When asked why the patient did not receive a transition supply of Geodon, when CMS policy had stipulated that patients stabilized on a particular regimen be covered during the transition to Part D, Eisenberg said here too CMS policy had been unclear: the transition policy pertained to drugs, but not to dosage amounts, he said.
   
   "The quantity of medication and dosage is one of the parameters that goes into our approval or denial of a drug," he said. "Until we got this information from CMS, we and other plans and the independent review entities were considering such high dosages as not Part D drugs.
   
   "Nowhere in any of the guidance from CMS did they go beyond mention of the actual drug to include dosage or duration," he said.

2. 2. dailypharmacist.com

   dailypharmacist.com/wordpress/ - [Cached]

   Last Visited: 4/15/2007

   In an interview with Psychiatric News, Edward Eisenberg, M.D., chief medical officer for Medco's Medicare business, said companies have had two sources of information for determining appropriateness of drug coverageâ€"FDA guidelines and four drug compendiaâ€"which have sometimes been in conflict. In the absence of clear guidance from CMS, Medco assumed that drugs prescribed at doses higher than approved by the FDA were not covered under Part D.
   
   When asked why the patient did not receive a transition supply of Geodon, when CMS policy had stipulated that patients stabilized on a particular regimen be covered during the transition to Part D, Eisenberg said here too CMS policy had been unclear: the transition policy pertained to drugs, but not to dosage amounts, he said.
   
   "The quantity of medication and dosage is one of the parameters that goes into our approval or denial of a drug," he said. "Until we got this information from CMS, we and other plans and the independent review entities were considering such high dosages as not Part D drugs.
   
   "Nowhere in any of the guidance from CMS did they go beyond mention of the actual drug to include dosage or duration," he said.

3. 3. dailypharmacist.com

   dailypharmacist.com/wordpress/ - [Cached]

   Published on: 4/1/2007   Last Visited: 4/15/2007

   In an interview with Psychiatric News, Edward Eisenberg, M.D., chief medical officer for Medco's Medicare business, said companies have had two sources of information for determining appropriateness of drug coverageâ€"FDA guidelines and four drug compendiaâ€"which have sometimes been in conflict. In the absence of clear guidance from CMS, Medco assumed that drugs prescribed at doses higher than approved by the FDA were not covered under Part D.
   
   When asked why the patient did not receive a transition supply of Geodon, when CMS policy had stipulated that patients stabilized on a particular regimen be covered during the transition to Part D, Eisenberg said here too CMS policy had been unclear: the transition policy pertained to drugs, but not to dosage amounts, he said.
   
   "The quantity of medication and dosage is one of the parameters that goes into our approval or denial of a drug," he said. "Until we got this information from CMS, we and other plans and the independent review entities were considering such high dosages as not Part D drugs.
   
   "Nowhere in any of the guidance from CMS did they go beyond mention of the actual drug to include dosage or duration," he said.