[MrPotatohead]

Medicare coverage of bisphosphonates during hospice?

by MrPotatohead on Sun Apr 03, 2016 11:50 am

I wonder if anyone has had personal experience - or else experience involving a loved one or acquaintance - in which the subject of Medicare hospice coverage for bisphosphonates like Zometa has come up.

Bisphosphonates are not curative of myeloma, despite the fact that some studies have shown that they can (in the case of Zometa, specifically, I believe), have anti-myeloma properties.

What is well established is that they do reduce the frequency of fractures, and also - either as a consequence of these effects or through some other mechanism - reduce myeloma-related bone pain.

Given these palliative effects, will Medicare cover their administration as part of hospice care? I have heard both "yes" and "no" from hospices I have contacted, and wonder what kind of answers others may have been given who may have raised this issue.

Thanks to anyone who has information he or she is willing to share.

[NStewart]

Re: Medicare coverage of bisphosphonates during hospice?

by NStewart on Sun Apr 03, 2016 6:39 pm

I would suggest that you call Medicare and ask that question.

Nancy in Phila

[Cheryl G]

Re: Medicare coverage of bisphosphonates during hospice?

by Cheryl G on Sun Apr 03, 2016 8:21 pm

Hi MrPotatohead,

I can't answer your question, and I think Nancy's suggestion is a good one.

But I have a more important question. Is your question a theoretical question that you're asking just to make sure you're prepared whenever theory changes to reality? Or are you really facing the possibility of hospice sometime soon?

Wishing you the best,
Cheryl

[MrPotatohead]

Re: Medicare coverage of bisphosphonates during hospice?

by MrPotatohead on Sun Apr 03, 2016 9:10 pm

Hi Nancy,

Medicare told me that it was up to the hospice and dependent on the specific medical case history of the patient; there is no hard and fast policy applicable to everyone.

Hi Cheryl G,

It is a theoretical question. More specifically, if I do need hospice at some point in the future, I'd like to know if I can continue Zometa. Right now, I am doing well on Kyprolis (carfilzomib), at least according to my light chain assays. However, as bone damage and bone pain are my major issues, I'd like to know what my prospects are for treating bone complications should I reach the point where I decide that hospice is my only real option. I am nowhere near that decision at present.

[NStewart]

Re: Medicare coverage of bisphosphonates during hospice?

by NStewart on Mon Apr 04, 2016 4:14 pm

Thank you for letting us know what Medicare said about the Zometa infusions. I know that Zometa helps with my bone pain, but hospice does make sure that you have the pain control that you require. If your myeloma is out of control and you are in the final stages of the disease, I wonder if Zometa would even be effective in managing bone destruction any more.

So much that we don't know about what happens in the end stages of life with this disease. We are getting really good at knowing what happens along the way until we get to the point where treatment is no longer effective.

You had a great question,
Nancy in Phila

[Cheryl G]

Re: Medicare coverage of bisphosphonates during hospice?

by Cheryl G on Wed Apr 06, 2016 7:37 pm

Hello MrPotatohead,

I am relieved to hear that your question is a theoretical one. I always look forward to seeing your postings here in the forum, and I would like to keep seeing them for a very long time.

Best wishes,
Cheryl